Balloons for the dead and a reluctant mother of God.

23-12-07

The year is almost over and the Christmas preparations are well on their way again. This is the most exciting time of the year, starting at the end of November with the election of a number of committees of 3 or 4 caregivers each, who together plan the activities over the days between Christmas-Eve and New Years day. Father Christmas, the presents, the wrapping of the presents, the other parties, the Christmas-play, the buying of the food, the cooking, the drinks, what kind of games, organizing the day of water games in the pool, the bonfire, the inviting of the various church choirs, a picnic if possible, all that and more. A committee for every activity.
The buying of materials for clothing for the kids has been done already (with a little help from friends) and the 63 or so dresses have been sewn by Ernestina



and wrapped up in parcels by Joyce and Dorcas. Every day we encounter new challenges, like how many goats to buy and where to buy them best, (here too we received a little help from friends), and how many bags of rice and how many tins of biscuits and how many crates of soft-drinks and what do we serve to our invited guests who will come to see the Christmas-play on the 26th.
A week ago Bob was in Sunyani to give a seminar for forty or so eager young Ghanaians who prepare to enter religious life. He offers them three fully packed days of introduction into Jewish Studies and this is quite an experience, almost like a love-in for the young novices. Bob loves doing it and they adore him.



So he came home announcing that all the forty young religious and priests will come to the Christmas play as well. Great! Where do we find enough chairs, drinks and cookies? The committee knows! Who else is invited? Hospital staff? Teachers from the Shalom school? Who else? Who invites? The committee! And if things run out of hand, which in all likeliness will happen every now and then, who do we blame? Of course, the committees!

Where ever I go, to town or to the hospital, I pass the new mortuary. The hospital road is the only passable way to get from our community to town, by now a very dusty road because of the dry season. The old trail which passes around the hospital and is situated at the back of the mortuary is now only used for ‘footing’, bicycling, or for trucks and tractors.
Some few days ago the Christmas decorations in the hospital went up (ours don’t go up till the 24th) and so the wards are decorated with garlands, plastic flowers and Christmas-lights. Nice! And what did I see since yesterday, despite the dust of the road, during my frequent trips between house and hospital? Bunches of bright colored balloons bopping up and down in the wind, attached to the front door of the mortuary!



Yes, real festive decorations for the dead! Or a cheer-up message to the survivors. And why not put balloons there, it speaks to me of the traditional Ghanaian optimism and resilience, those decorations at the front of the gloomy mortuary. It makes me smile every time I pass there.
Maybe the balloons have another reason too them hanging there, which is to attract attention to the front door of the mortuary, that is to say not to the back of the building! For wicked tongues keep whispering that there are two ways to pick up the corpse of your deceased family-member when you are ready for the burial. One is through the front door where your car can park neatly and the corpse can be transported in a dignified way. For the full price, of course. And the price to pay for storing a corpse in this cooled mortuary can be quite unaffordable, especially if preparations for the funeral have been delayed, for example because of relatives form overseas who want to return to Ghana but need time to prepare for their flight. Those kind of things.
So, what can be done if finally the funeral is arranged but there is not enough money to pick up the corpse from the mortuary anymore? Well, these wicked tongues do keep whispering that at night, under the cover of dark, people can pick up the remains of their beloved family, for a good price mind you, at the back window of the building. There are no lights, it is pitch dark and people would normally be scared to go there. So the bodies are ushered out of the open windows at the dark side of the mortuary to be caught by the relatives who then transport the corpses on little trolleys, trucks or wheel-barrels over the old trail at the back towards a waiting car parked somewhere unobtrusively in the shade. Not as dignified as the front door but’ hey’, what can a poor man do?
It seems that there is quite a profit made from this back-door trafficking of corpses and thus a loss to owner of the mortuary, which is the Bishop of Sunyani. I even hear that the hospital management agrees that this happens but…. There is a problem tackling the problem! The mortuary staff consists of trained workers; they are scarce. If someone from the hospital management would even just confront any of these mortuary workers about their shady deals you would most likely lose them to another mortuary! They would wipe their feet and go for another of the many vacancies as mortuary-man in Ghana! And who would then know how to run these complicated cooling machines and manage this whole macabre place? Right, the corpses would defrost and it would generate a public disaster. Especially a disaster in Ghana where respect for the dead and the traditions around funerals would not tolerate anything like that at all without much outcry and huge articles in the papers. Bodies may not always be treated properly but corpses absolutely should! So, whisper but not too loud and if you hear funny sounds at night turn on your other side and continue to sleep, live and let live as they say!
We should find out who has put the balloons at the door. If it is done by the hospital management it may want to say: come to the front-gate please. If on the other hand they are hung by the mortuary man then they may be celebrating their work-place, their good work and flexible prices and their monopoly in the market! Enough with the balloons.

Wednesday night the external students of the sheltered workshop had their end of term party before going home for Christmas. Angela had organized a beautiful party full of fun and surprises. Not only new poems and dances by the ‘work-shoppers’ but the choir of the workshop sang the national anthem and other songs conducted by nobody less than Conducter Master Dela! It was a grandiose performance and Dela has immediately risen as a star!



And then Friday afternoon the final dress rehearsal of the Christmas-play took place. The final rehearsal has always been better than the performance itself! Mostly because no-one is nervous and there is no noisy audience coming and going to disturb the actors.
After much deliberation it was decided that Moses should be the baby Jesus. The youngest among us is actually Emanuelle, but you cannot just keep throwing Emanuelle high in the air! You can’t be too wild with her anyway, for Emanuelle is a little dainty lady! By the way see her here in her new dress and surrounded by flowers on her 3 rd birthday, which occurred on the 17th of December.



The next one in age is Kwabena. He is three and he should be it, but he is too heavy! He is neither a gentleman nor dainty but he cannot simply be thrown very high in the air for he is to very heavy! So who is left? Moses, lucky guy Moses, second time around. Mary and Joseph are played by Afia and Kofi Asare again. Kofi is usuually full of enthusiasm for whatever he does but with With Afia it is another issue. Reluctant to sit at the manger with Jesus she had to be lifted up and carried on to the donkey-cart which stands for the crib where Jesus was born. Once seated she expresses her displeasure by stubbornly looking into the air, as far away from the newborn baby as possible.



During her long sit there she would not once deign to turn towards her newborn baby, let alone look and reach out to him. Not that Jesus minded, for he was rolling around in the palm-leaves in the donkey cart (the manger), and threw his long skinny legs repeatedly over the edge of the cart to let them hang. Ready to jump off too! He wanted to sit up and see what was going on of course. Rather roughly he got pushed back into a ‘Jesus-like” posture but time and time again he climbed up and over the edge of the car. Finally one of our good caregivers pushed him rather mercilessly into the leaves for a



good Jesus does not sit up and look around like a four year old ready for any kind of mischief!
Behind the manger the sheep were sitting, the wheelchair-sheep. They just sat, Alice, Inno, Lisa, Aaron and Wumpi. On the left, on a rug, sat the autistic sheep. They too had no voice.
The caregivers, who stood in for the voices of the sheep did, with much display of talent, the ‘meeee’ sounds as well as donkey sounds and in fact had so much fun together that it made up for the lethargy of some others, like Mary the mother of God.
King Herod is as always played by Kojo Evans, who has the composure of a king. Over the year the Emperor has grown a family, first his wife the Empress YaaYaa, who, clad in gold, sits at his side on the throne, and now also there is a prince and a princess, PaaYaw and Manuelle. Sitting at their feet are the servants and linguists, barefoot and clearly of lower rank. This is the spirit of Ghana, a king should not be alone, and rightly so. So that royal group is an eye-catcher. I call it the golden corner.
Probably the baby Jesus should be at the center, should be the eye catcher. But what with a mother beside him he looks completely the other way in disgust? And a Jesus who wants to play like a boy rather then lay there like a sacred bundle? Well but at the end things come right for Jesus is radically taken into the strong arms of Ema and then all the



caregivers and the sing and dance and drum and throw him higher and higher, and amazingly enough catch him every time again. No doubt he is at the center of attention now. And all is well that ends well. If only he would not end up in the top of our house-tree, now called our Christmastree, because of the big red flowers in its top.

We wish you
a wonderful Christmas
and
a good 2008!

Lazarus and his women

Dec 16th 2007

Having to occasionally review the web-pages of the children on the internet is a good way to follow their progress in development. Take Lazarus. That web-story about Lazarus was written a little more over two years ago. At that time Lazarus was one of these kids who nobody would notice. Even now people don’t notice him much. One might ask ‘who is this boy who seems to fall over his own feet as he runs towards me?’ Or hear his primal scream and powerful roaring from even the other side of the hill without realizing that it comes from the mouth of that shy and unobtrusive Lazarus!
Below is his readjusted story as it will appear on the children site, the original is still on the site right now. (For comparison!)

Lazarus is a boy who was probably born in the beginning of the nineties. In 2001 Lazarus came from the mental hospital in Accra to the Hand in Hand community. At that time, he was in a bad shape. He was emaciated, did not talk or make eye-contact and was sitting all day long by himself, digging his fingers into the soil. That was the only contact he seemed to be able to make, touching soil.
He has always had an awkward way of walking whereby he seems to fall forwards all the time.
Lazarus still is a quiet boy and he still spends much time by himself, but not all the time anymore! He has received a lot of special attention from his present caregiver and from various volunteers and it has started to show. Lazarus has started to enjoy the mealtimes and he is willing to eat, even eat with gusto, as long as he keeps receiving the attention from ‘his special women’.
Lazarus never talked or made a sound. That is to say up till the beginning of 2006. And then one day a piercing cry was heard. It was over before it had begun but it was a loud cry and it came from the mouth of Lazarus, much to his own surprise probably! We now call it his ‘primal cry’ which apparently can be heard all the way in the surrounding hills. What feeling he expresses with the cry may be guessed, for all we know he simply shows that he exists! So with this cry Lazarus welcomed himself into the land of the living!
But this year he has developed another sound, he does not only scream but can roar like a contented bear, more powerful and more earthly than his early screaming. Plus he is now able to make eye-contact and keep locked into someone else’s eyes for a long time. He then looks surprised as if he cannot believe what beautiful things he sees!
Now we does not receive much extra food anymore, as he has become fat like a young chief. So, over the last two years a miracle has happened, Lazarus has resurrected!

In December 2001 a woman named Nienke, volunteer at the psychiatric hospital in Accra, had decided to fight for Lazarus’ life which eventually resulted in him being transferred to us. She was the first woman I know of, who decided to make a change into his miserable life- circumstances.
(Maybe his own mother had tried long ago, who knows. Maybe she failed against a pervasive family pressures to do away with him, being a ‘misfit’, the child of a spirit maybe. Or possibly there was no mother anymore.
No-one will ever know Lazarus’ story before he was found on the street and it is not even known when and where he was found, and how long he has stayed at the psychiatric hospital in the capital, warehouse for lost ‘misfits’, like him.)
When he came to us he was more dead then alive, certainly in a psychological way. He stayed with various caregivers but did not thrive with any of them. Lazarus was an almost invisible dark boy sitting onto the dark earth. He would not sit cross-legged but with his knees pulled up like a fetus. He spent a few years like that, till Veronica arrived, in 2005. She became his caregiver, the second woman of substance in his life.
‘Vero, would you look after Lazarus? He needs a lot of attention; we do not even know where to start. Why not start with food, let us see if he can gain some weight?’
When Vero first joined us she herself was a skinny and shy girl, who hardly spoke. You could see her walk with him, take him or her back and feed him with endless patience, apparently all in vain. He refused to eat and his only comfortable place remained a din in the soil where he would sit for hours, preferably naked.
Another woman made her appearance in his life, the volunteer Joti. She begun to help Vero with the feeding of Lazarus. Vero at first looked a bit fearful at that volunteer who would take over ‘her’ Lazarus, it was almost like an unfair competition. But those feelings got healed of course. When Joti left in the early summer of 2006 Lazarus had gained weight and started his little, but still abortive, runs towards people, looking them for a moment in the eyes and then running away. He had started giving such piercing screams that you could hear them from very far! His primal screams!



Vero, now very happy herself with the progress, continued to feed Lazarus big plates of food. So he has now become fat, like a little pasha! That is how he comes running towards you with his scream and then at the last moment averts his look and stops short of you. Shocked at what he has done, come too close to people!
Vero and Lazarus were content together. On top of that volunteers kept coming and going, all trying in their own way to help socialize Lazarus and help reduce his extreme social fear-level.
Recently Lazarus enjoyed another ‘break-trough’; he developed his ‘lion’s roar’, a loud but good humored rumble of throat sounds that probably wants to say ‘I’m here and I like life today. How about you?’ Also during this time, very recently, he decided to run straight to you, looking at you till you are face to face, eye into eye, with him. And then he delights and even wants to be touched. Lazarus has truly come to life
!


This last development occurred during the stay of his newest special woman, the volunteer Carolien, with him. Between September and November of this year Carolien and Danielle were here and among others Lazarus has gained a lot from them.
That’s the story of Lazarus so far, the chief with the highest number of special women in his life!

No Catarrh today, please

December 9th 2007

It is 8.30 am, a very cool and pleasant Sunday morning. It’s time to get up from the breakfast table and start the day, but there are children gathering, YaaYaa and M’Adyoa and some few others, standing around our table, with running noses and dry coughs and all that. The ‘consultation hour’ for our own staff and children who don’t feel well takes place right after breakfast and everybody knows that. Also since about one week the dry desert-winds have started blowing from the north, wind loaded with dust and Sahara sand. With it ‘catarrh’ is our daily companion again for the months to come. Already people have started complaining of dry skin, cracked lips, sore eyes and especially colds and catarrhs.
I see them gathering around the table with their colds and running noses and before I know it I am already halfway another sermon. “Boys and girl, no catarrh today, please! The clinic is closed for catarrh today! No running noses, no coughs, no common colds, sorry! Today the shop is closed! The paracetamol is with Ema!”
Big eyes, what is she saying now?
More people come, I see a line of persons forming and walking towards me from the summer hut, Philo and Moses in front, with flowers and a scroll.
Oh God I misfired, it’s for my birthday.
Acutely red faced I change my expression from irritation to benevolence and jump into attention, ready to bow and accept the flowers and the scroll with text. “Happy Birthday from all your children”.
They then sing ‘Happy Birthday to you, Happy birthday to you’, the whole thing, up to ‘How old are you now?
‘I’m 36 years old now, I’m 36 years old’.
May God bless you now-ow, may God bless you now!”
Thank you wonderful catarrh kids! Remind me next year this time to look first and not be that immediate in my reactions!

Being ill, part three (and last, we hope)

Dec 1, 2007

The past week we could not still get out of the ‘being ill era’. Of course working in the hospital makes it hard to get out of the realm of illnesses but I mean something else of course, illness personalized.
After Bob returned from the hospital the Chief visited our house. The Chief and I know each other since his election more than twenty years ago, and during the last fifteen years or so he has become increasingly close. At our wedding in Nkoranza in 1997 he was my surrogate father who threw the traditional feast and from whose arm I was given away to my husband Bob. We like each other a lot.
The Mercedes with the little flag stopped right in front, someone rushed in to announce the visit, in came the policeman with the rifle and there was Nana himself, traditional cloth dignified over now sagging shoulders.
Nana showed me a bundle of X-rays, ECGs, lab-forms and prescriptions, together with a referral letter from Dr. Boateng, physician in Techiman. ‘Recent myocardial infarct, bronchopneumonia, should be urgently admitted but refuses’.
‘But Nana, with a heart-infarct you need to be admitted to hospital! I mean really, please.’ With the help of the nurses we quickly made a hospital-bed ready for him and almost pushed him on it. But he refused. So I ended up doing what I have done before, which is to admit him in one of our guesthouses here at PCC. However with nurses from our hospital attending to him. He feels more comfortable that way. It IS more comfortable that way!
So that was done and Nana settled down a bit. The nurses could administer the medicines and our community suddenly felt very safe with the policeman with his huge rifle in front of our gates, on guard for 24 hours a day. (There is a chieftaincy dispute raging in Nkoranza traditional area and the position of the Chief is envied by opposing factions, that’s why.)

So, weekend. Nana looks gaunt and ill, he coughs and has difficulty getting breath. ‘Nana, I wish you were in Accra. You need a cardiologist. We need to test the state of your heart-vessels. Coronary arteriogram. Things like that. You may need very specialized procedures. You need not be in a rural place like ours, though it is good for now.’ It became a long and frequently interrupted discussion over the weekend but then Nana did agree to be admitted at the excellent military hospital in Accra. Nana is an ex-service man. We decided to attempt getting an airlift from Nkoranza to Accra. From that moment until Tuesday morning the phones never stopped. Calls to ‘medical emergencies’ of the military hospital, popularly called ‘37’, calls to the army base at Sunyani, calls with Lieutenant Hanson and Captain Dela and finally, Monday 10 am, Colonel Appiah from ‘Northern command’ on the phone. ‘Doctor, can you transport him to Sunyani, your patient? So we get him onto a plane from there to Accra?’ ‘Yes, Sir. Yes, Colonel, we can do that.’ ‘In how much time from now?’ ‘Two hours or a little more. We have to get the ambulance here and all that. 11,30 am.’ ‘Why not earlier?’ ‘Because, colonel, it takes two hours by road from here to Sunyani. Besides we have to go slow’ The voice says: ‘Wait, hang on. I’ll call you back’.
Excitedly I run towards Nana’s guesthouse with the good news, but at his doorstep the phone in my pocket rings again. ‘Colonel Appiah here. Please Dr. Bosman prepare to be ready in 40 minutes with your patient. A helicopter has been released. It will survey the area, see if it can land in Nkoranza. At the hospital-land, possibly. Be ready when it touches land. A nurse to accompany him’
I get more excited and repeat the words to Nana, who, like a soldier, is not excited at all but says ‘That’s right. Thanks Ineke. I will prepare then’.
A nurse in 40 minutes, I do it the wrong way around. Ask Vero, the nurse who is like a soldier herself, a tough cookie and an excellent nurse. She says ‘Yes’ and laughs. I got to know that laughter very well over the last twenty years or so, always expressing great spirit. I then inform and ask permission of the hospital authorities, the ones that are there. They agree of course but look strange, this being the first time in its history that such an airlift takes place. Then…all is ready after half and hour or so and Vero, Bob and I sit at the gate with a cup of tea waiting for the sound of the helicopter in the air. Nana rests on his bed. Waiting. Nothing. Two hours later. Nothing. It is getting to 12. I have called the colonel twice and he assures me the helicopter is in the air. From Bolga to Tamale, from Tamale to Sunyani, then fuel in Sunyani, then pick up in Nkoranza and straight to Accra military hospital.
It’s going to be 12,40, he finally calls me. They will be there at 12.40. Be there with your patient. 12,40. Exactly 12.40.
We sit at the gate still. Vero has eaten, thanks to Charity. Nana only eats food prepared in his palace. Has he eaten? He says yes. He may have, we let it go.
And… here it suddenly is, the steel bird, right above us, with an enormous rumble in the air! The helicopter flies so low that a kid could try to jump and catch its landing gear. A man look outside and down from the cockpit. Yes! We jump in the car and follow the noise, and there it is right in front of us, landing slowly and totally stationary on the little open field at the hospital premises. Too big for life. Branches of trees swept away and broken off. It has landed. The sound is overwhelming, so is the wind.
The pilot, someone with a nametag ‘Ismael Abbas’ descends and shakes my hand. We all make gestures for talking is not possible. (Should have had Joshua here!) The car of the Chief arrives and in no time he is hauled into the back of the helicopter, together with Vero.

Ismael Abbas salutes, get back inside, pull the helicopter back into the air and heavily it sails over the hospital buildings into the far distance. Leaving what now seems like all the inhabitants of Nkoranza assembled open mouthed and sprinkled in dust on that hospital-field.

In a memorable way Nana has left Nkoranza. May he be well. Two hours later they had arrived at the hospital and Nana was admitted to a private room, after a new series of tests. Thank you Colonel Appiah. It was 12,40 sharp. Perfect airlift. Only one I have ever witnessed. We are impressed. We talk about you and all your wonderful outfit over here!

This must also be the end of the series of illnesses that were too close for comfort. Time for a break!

Being ill. Part two.

Nov 23rd

Last Sunday I was recovering well, not knowing that in the meantime Bob was cooking up a fever. During the night he calls me, ‘Ineke, come please’. I come and see how he is all curved up, and shrunk, and chilling. I do not understand what he says till I realize he doesn’t either. Thermometer: 39.6. It’s 9 pm and I start helping him up, then realize he is too heavy and so I get help. Vincent, Baffo, two strong guys take him on both sides into the car and we drive to the hospital. Third trip in three days, other than for work!
The bed where I was laying before is empty and I inform the night-nurse. My husband comes for admission, please. We haul him in, on the bed, Vincent lifts him up and shifts him higher in the pillow. Bob is out of it, on top of it he vomits right there and then, copiously. Vincent gets his face to the side and Baffo gets Charity to get towels and water to clean and chill him down. An IV, artesunate intra-muscular and yes…he looks at us from under the wet towel: ‘Hi’. We grin. It is so nice to be alive, believe me! The temperature comes down because of the cold water or maybe a dysfunctional thermometer, who knows. He gets better, ‘What happened? Can we go home now?’ The IV runs in, the pressure gets normalized, the vomiting stops, at twelve we go back home and Baffo and Vincent drive us, carry him, do everything. Slept, both of us. Somehow. Next day: Hmm, better. What was this? The malaria slide was negative, though of course he continues the malaria treatment. We are content because we are both alive and getting stronger. Though ultimately tired. Monday all well. Nieske gives a party that night, it is her birthday. What a birthday! The party is nice, Bob even sings. Then the night. ‘Ineke!’ Chilling again, pains, crumpled in bed, confused. I call all kind of colleagues, included my good neighbor Harry Wegdam, the surgeon in Techiman. ‘Get him IV and antibiotics, always think of a urinary tract infection, it’s hot, he is getting old. Look at his urine, I bet you…’ We arrange the admission again with Dr. Aboagye, who takes over as I am starting to collapse under multiple roles of being wife, nurse, physician and still a patient myself. There Bob lays, on the hospital bed again, now the one where Geordie was laying a week ago. This is the only bed near to a functional toilet and right in sight of the nurses-station, hence called sometimes also ‘intensive care bed’. We are doing musical chairs, the nurses laugh. But I can’t laugh and look at my husband who is surrounded by caregivers and is receiving the same intravenous antibiotic that gave me an allergic reaction two days ago. He is improving visually! Do I expect in him the same reaction I had towards the ceftriaxone, are we so close that I expect him to have my kind of body-reactions, maybe? (He did get ill when I was ill, after all!). Of course there is no reaction, except a beneficial one. The urine is collected, he gets a fright from it, ‘looks like blood’ he told me later. I missed it, was already at the lab to be analyzed. Yes, pus-cells. My dear neighbor Dr. Harry Wegdam you were right!
That Tuesday was hell, but a sweet one. If that combination is possible. Hell for the fear, sweet for the healing. I walked in and out from the ward, towards and away from his bed, saw him getting a normal color again, saw the temperature curve reaching normal values again. That night Joyce, good old Joyce, stayed with him the whole night. And Kwame, and Baffo, and Ema (who was on duty as a nurse!) and oh all these sweet people all over again. Geordie! I excused myself after Harry had come and gone that evening, to make sure that Bob was getting well. I went to bed at seven in an empty house with my dogs and shamelessly slept till the next morning seven. And knew he was well. Which he was! Look at that picture, taken Wednesday morning. Surrounded by loving people, his color back, and so much better! That evening he came home and since we have been celebrating life! Gently. Carefully. Gratefully.

Harry, Mariette, you neighbors of substance! Should I say thank you? What we both feel is so much more than can be contained in a ‘Thank you’. Your lifestyle, your professionalism, your commitment, your sense of humor. You, Wegdams, have been our good neighbor for over ten years. For all these years we have been friends, the best of friends! What was special is that we did not have to proof this and perform the ‘petty things’ for it, like drinking coffee, remembering birthdays and all the stuff like that. We were so good friends we did not need them, not at all. Not at all and that is special!
You saved Bob’s life, do you know that? I think you did. What do you say in such a case? Thank you? Because of you the world is a little lighter, do you know that? A little bit more beautiful. A bit more hopeful.

Being ill

November 17th

If I had written yesterday this story could have sounded mostly funny. But since I write it today, and this morning I caused a wave of anxiety in and around me, I’ll be careful not to write too lightly. It is Saturdayafternoon, hot. I sit with the laptop in bed, want to process and capture the recent experiences before going to sleep again.
Yes it is a funny, but most of all a heartwarming little story, very heart warming, about me being ill.
Yesterday morning I started my first operation, Friday being my surgical day in the hospital, and after I had already made the incision, a little boy with an inguinal hernia, I could not suppress waves of nausea anymore and had to throw up in my paper mask. Not very appetizing, but what to do. I aimed beside the operation field into a bucket that was hurriedly shifted my way. The circulating nurse removed the mask with sticky contents from my face, threw the lot in the bucket and wiped me clean with a wet towel before I carried on with the proceedings. My old tropical doctor experience kicks in handy at those moments: whatever happens, ‘the show must go on’. Quickly I dissected the hernia sac and left the closing up to good old Sister Comfort who has been doing these kind of things, perfectly, for the last twenty years or so. I felt like collapsing and walked or rather was carried away from the operation room to the ward where I tumbled on an empty bed and had to throw up again. Bed number 1 of the children-ward, that’s where I was laying. The bed beside that of Geordie who was admitted there a few days earlier, with the same kind of symptoms. The ward-sister, Sister Vero, my old girlfriend, gave me an IV, injected a malaria shot and administered an IV antibiotic, being the ‘Ghanaian answer’ to a medical situation where action is needed but no diagnosis made as yet. That and then Vero’s laughter and a friendly smack on my buttocks as if to say ‘we are here, don’t worry’. I start feeling better except for an increasing itching from head to toe as if a colony of bees passed by, African bees! The curtains around my bed have been carefully closed on three sides as if I am dead already, but no, on the fourth side I see a very pale Bob sitting on a little chair close to the bed. “You look well, honey, I’ll stay here with you” he keeps mumbling softly. Beside him Joyce is sitting. She holds my left hand and will keep holding it for the next six hours or so, the hand with the IV needle in it. Kwame stands beside her, solemn and severe. Than I see the face of Baffo, concerned but with his little twinkle in the eyes. Thank God, because the way everyone else looks at me is very unsettling. Especially Bob’s somberly repeated ‘you look well, honey’ is ominous! Nieske, oh that dear sweet Nieske, she sits at the foot of my bed and rubs talcum powder into my skin, everywhere where the hives jump up, which is everywhere where I have skin, but especially over my hips and trunk. It helps a little, against the itching. Geordie appears with his boyish smile and his deer-like eyes: ‘He, doctor, the roles have reversed?’ I lift up the curtain towards the other side of the ward, try to spot the baby who was just operated, and his mother. I see them. She is looking straight at me. I try to wave as if to say ‘it’s all right, the child is all right, all is well’. It makes me laugh all the same, but would have been more fun if I had felt better, and specially if the mother had been reassured already that all was well with her baby. Which I now doubted for all attention was ‘on the collapsed doctor’. Of course that mother would be looking with great big eyes to see the doctor coming out of the operation-room into the ward and onto a bed collapsing and vomiting and generally being sick. While her child was still in the theatre being stitched up and dressed to make his reappearance into the ward again, later. She would want to shout and say ‘hey, what happened to my child’. But this is Africa. She would be too shy to raise her voice. Generations of parents, grandma’s and teachers have instilled this advise into their children ‘Be patient, my sister!’, and how could she overthrow her culture at this moment, all by herself?
‘Did you finish the operation?’ asked Geordie. ‘Yep.’ I believe that Sister Vero reassured us she would tell the mother that all was well with the baby. (And, while writing this, know that she, or someone, has explained her.) Vero too had the giggles about the situation. All the same she has a lot of feeling for her patients, absolutely! Maybe somewhat rough but totally heart on the right side. In the meantime Vero feels for my hectic itching and scratching too, and she shoots a good dose of hydrocortisone through my veins. It helps. I start to relax and see the small world around me in a different light, warm, clear, intense. Maybe a lasting memory is in process of being made. I feel small throngs of joy now that i surrender to the situation. I see faces appear between the curtains of my bed, one after the other. No, not appearances…! Faces. The faces of our caregivers, Ema and James and Vero and Felicia and Janet and Charity and Grace and Gifty and Mercy. A swarm of midwives and nurses, one after the other, one after the other. kind faces, all kind faces. Some shy, some worried, some polite and some humorous! (Janet humorous!) Finally arrives my colleague Dr. Aboagye, who immediately throws in his authority. He solemnly jots down his ‘history and treatment’ notes, thus turning me into a formal admission on the ward. He shakes my hand, smiles a ‘speedy recovery’ into my eyes and continues his now doubled busy Friday-duties. I was on duty and as we distribute duties among the two of us the duty was now his. I am ill, he is on call. He is away, I am on call. Simple.
The hand of Joyce. That hand not only held mine during the six hours or so that I was on admission, but also streamed energy into mine. Very tender but strong motherly energy. No wonder that her children Emanuelle and Innocencia are thriving so well. What a mother they have, I have now experienced it. When I try to disentangle my fingers from her hand she smiles and brings her other hand to let my freed hand rest on, before she takes a stronger grips of my hand again, all the while squeezing it reassuringly. Whoosh, what a string of awkward words just tot try and describe ‘hand in hand’. It is our community’s emblem indeed!
So I let myself be pampered by Nieske and Joyce. And I doze off to sleep again. When I wake up this time it is almost three in the afternoon. I feel better. And I see that Joyce is still sitting there, carefully holding my hand. ‘Did you eat?’ She laughs. ‘Took some tea maybe?’ She laughs. ‘Have you been sitting here all this time, with my hand into yours? ’ She smiles. ‘Yes Maame’. Oh sweet dear, you!
I don’t itch anymore. There is no more vomiting. I have no fever. I want to go home. Oh and if Ineke wants something she will get it too...and immediately, or almost immediately anyway. ‘First you have to finish the IV and then you can go. Even though Dr. Aboagye has admitted you, but anyway I will explain it to him. Go at four. Tomorrow come for the next injection. Ceftrioxone. 2 grammes.’ So says sister Vero, and smacks me friendly on my hip again. I love her. She goes, she is out of field of vision. I regress 60 years, become a three year old toddler, look at Joyce and grin: ‘conspiracy’ to her! Then I reach for the IV and open it more fully so that the last 100 cc dextrose saline runs into my veins like a sparkling gay little current. Joyce looks at me and shakes her head, no, no, but she has become a child too, I see it. Joyce and I grin together while she squeezes my hand. I call Baffo to come and collect us please as I am now discharged. I am free. I have cheated. I feel well for having cheated and being free. Childish but it is nice to be a child again!! Vero is ever busy and when she passes bye again, her eyes on the IV bag, she says yes, finished! I’ll disconnect you, you call your car, you may go! She and I are action-people, we both thrive on pressure, admit it or not. That’s why we are friends I think. Baffo is already there of course, so is Nieske, Bob, Kwame, Ema, the whole chorus-line. Joyce holds my disconnected hand. Are there three cars to bring me home? Fine, let me be a queen who is escorted home in style. At home I’m ‘laid in state’ on the old coach to be once more greeted and inspected by all the bigger kids and caregivers of the PCC. And the dogs not to forget. Her majesty has returned home! Everybody is reassured and I fall asleep. Midnight. Awake. I feel my face, my face feels like rubber, strange. I look, i do not recognise my own face. ‘Bob look at my face?’ Yes? What? ‘All swollen up!’ No, looks okay, is fine, go sleep. ‘God’, I think,‘Does your house have to collapse over you before you will notice anything at all?!’ I try another language, film-language, one of Bob’s favorite languages. “Do you remember that film, true story. A young guy with congenital problem. His face for ever more swollen and disfigured? Elephant-man?’ ‘Ah, yes! No not you, go sleep!’ I go sleep again.
The next day, today. I feel better apart from a splitting headache and that elephant face. My eyes can’t open anymore. “I don’t believe I can work like this I say. Of course you are not going to work, Bob says. I mean I can’t go to the hospital for this injection now. Can’t even move. Joyce comes, takes my hand again. “No’ she says,‘No work. I will call mr. Hippo’. Mr. Hippo comes, my old colleague the medical assistant. He and I have been connected to this hospital for 24 for years, and to each other. For better and for worse. He is always there and I feel free with him. He comes to give me the injection at home and then make rounds as Dr. Aboagye has gone of to Kumasi this morning. He promises to call me before sending surgeries to Techiman, in case I am better. As the duty seems to have come back to me again. He shoots the second gram of ceftriaxone in my veins. The itching starts again, I feel it coming up together with the drug entering my blood. He is done and I too stand up, scratching, dancing a strange St.Vitus-dance. Need to scratch and it is agony! It goes to my scalp, legs, breasts, hips, it is agony. He sees it. “Ah, you are reacting.” “Allergy”. Then I come with him into his car and to the hospital, another injection of hydrocortisone. There I stand, near the nurses station, Vero is there again, she has injected me and wants me to be laying on that same bed again but I want to go home. Basically because I want to scratch at places where you can’t if the mother of the baby that you operated upon is standing there looking at you! (Those who know African hospital settings have not to be told about their lack of privacy.) The other cars come following Mr. Hippo and me. Here come Baffo, Nieske and Bob again. Now Bob is gray from worry and walks bend over between Kwame and Ema like an old man. Baffo and Nieske are the more ‘practical duo!” I am burning but had the hydrocortisone and insist on going home, which means Bob and Baffo and everybody has to turn again to follow Hippo’s car again back home!
Poor Mr. Hippo wanted to give me an IV on the ward, but it now hangs smartly from the curtain-rail in our house while I sit on the coach. Joyce holds not only my hand but my legs too, with cold wet towels against the burning. Nieske is there, she helps. The reaction falls away almost as fast as it had begun and I soon feel better and slightly sheepish too for having overreacted. The IV-bag is empty and Ema removes it. He does it perfectly. Don’t forget that Ema is now a nurse, not just a caregiver who coordinates other caregivers, but a nurse as well. He’s proud of it and I saw it. The way Mr. Hippo winked at Ema and said ‘Aren’t you a nurse now? Can you keep an eye on it and disconnect it when it is through?’ And Ema said ’yes’ and did exactly so, radiantly.

And now the second storm has gone down and I have retreated to my bed, with the laptop. It is hot outside, Saturday-afternoon. Charity told me: ‘You really made us scared. Maama, don’t do that again please, don’t be sick like that, not jumping and running like that and with that face so swollen!” ‘No’ I promised her. ‘I’ll not do that again’. I could say it with some confidence, once I got to know the whole thing was an allergy against ceftriaxone. Simply avoid it in the future, that’s it.
‘But, said Bob, you were ill before you got ll that stuff inside you to make you more ill so now go rest and don’t do duty this weekend, i beg you please. Give your body rest. ‘I thought you saw nothing wrong, Bob?’ ‘Ah Ineke dear, this kind of avoiding pattern I have learned from childhood onwards, can a very old fox unlearn his very old tricks?’
‘No, me too. Whatever I have, part of it is augmented by panic. I wish to suppress it but simply can’t. You know, I could have scratched myself very, very discretely!’
This is heartwarming, to be as we are.
Heartwarming moreover the care of all these people! Yes I know that in Ghana a sick person does not normally lay by himself alone, but here was more at stake. And it has really warmed my heart, it has done me well. I am not only the usual boss, a nasty one at times, but they showed me just how much they care for me!” That is rare, that is a memory not to forget Next time I feel alone at the top.
Oh and the mother of the boy who had his operation done yesterday was standing beside me in the ward when Vero gave me the anti-allergy injection this morning. She nodded at me. Which means that she doesn’t worry anymore about her baby. Which means someone has told her the strange story of the collapsing doctor who left her child ‘alone’ in the operation room and that all has ended well with the surgery. And with the doctor! Oh, Ghana. Oh people!

Not to forget Joshua

November 10, 2007

Towards the end of October, just before Bob and I went for a vacation to Israel, Joshua was placed ‘on probation’ at the Jamasi school for the deaf. Joshua is deaf but is on probation because his IQ was measured to be 50 by the teachers of that school. We definitely knew of course that Joshua is far from ‘an imbecile’ (as they formerly called people with IQ’s under 80). In fact he may turn out to be very talented. But once a diagnosis and a number has been jotted down on an official piece of paper it is hard to undo its harmful effects. However, however. To make a long story short the headmaster agreed that Joshua should come for a probation time and so we very quickly shipped him off to school (which is near to Kumasi, some three hours drive away from us) before the teacher could possibly again change his mind.
When he stepped in the bus that certain beautiful morning, in his yellow and brown school uniform, new backpack on his back and rolled up student-mattress under his arm, he radiated from excitement and looked like any Ghanaian student setting off for boarding school for the first time. He was fearless, and that while he is a seven year old child, abandoned and raised in an orphanage from where he was again ‘abandoned’ to our community to again be ‘abandoned’ to this boarding school for the deaf. When, according to Kwame who brought him, he arrived at the school some hours later, he was received very warmly by the housemother who was going to look after him.
When Joshua had taken in his new situation and finally looked around for Kwame, Kwame was already in the bus and waved him goodbye and left. Little explanation and an abrupt unceremonious farewell, as usual between parents and children in Ghana. Tears are bad news, embraces are something reserved for comings, not for goings, and the Ghanaian child is trained from early age onwards to avoid emotional scenes.



So when Bob and I returned to Ghana, two weeks later, one of the first questions was ‘How is Joshua doing?’ Good, the caregivers said, good we hear. But no-one had seen him yet in his new school, the news was from telephone calls. I did not know but every now and then Kwame called the housemother of the school over the phone to follow Joshua’s progress from afar. Joshua immediately behaved the ‘right way’, as a good child, Kwame and our caregivers say, because even in the beginning when he realized he was once again alone in an alien surrounding he sucked his thumb and got on with his life in a most positive way
The G8 was then here and needed another busload of plywood to make more furnitures for the kids, so Kwame was charged to pick up those and other building materials in Kumasi. To get to Kumasi you pass the little town of Jamasi. So on the way back Kwame took it upon himself to stop at the school and see how Joshua was faring. Thank God for in our ‘busy’-ness we did not think of that possibility to meet Joshua, nobody did but Kwame.
“Oh and I went to visit Joshua!” “Joshua! My God! Well done! How is he? How did he respond to you? How did he look? Is he happy?” “Yes. Well I arrived and he saw our little bus. He seemed to recognize the bus but at first for a long time he did not recognize me. I walked towards him and he just stood looking there, looking at our car. And then, suddenly, that enormous smile! And he came running to me!” “Yes he looks well, well fed, and they all seem to like him there. He is doing well at school the housemother says. We should send more food and some other things, things that he needs.”
It is such pleasure to get a life report of how our little boy is faring and that up till now his curiosity and his zest for life wins from any form of anxiety. And that he is our boy who convincingly defies the outcome of his and of course any western IQ test done in these rural African settings. It compares maybe to making an X-Ray in the full sunlight. Try to interpret that one without 99% grains of salt.
Kwame met Joshua for maybe half an hour and off he went again, back home to Nkoranza with the building materials. Life went on, pleasantly and busily, and before we knew it we had forgotten Joshua again. Till Kwame alerted Bob this week: ‘I need money for this and that and that for Joshua and I will bring it coming Friday’. Oh God Joshua, how is he doing? What will you buy? Chocolate-milk, milk-powder, shito, a second pair of shoes, what else? Can I not talk to him on the phone? Oh no of course not, he is deaf. Go, go soon, ask when he can be picked up for the Christmas holidays, what day, when we can come for parents day, greet the headmaster from us, etc. etc. Christmas is the time we all have to learn signing. Ask the headmaster how you say ‘Happy Christmas” in sign-language! So Kwame has bought all the things and is ready to go and then surprise surprise, the day before Kwame was to go bring Joshua his goodies, some Dutch people came to visit us. They are teachers for the blind in Holland, giving courses at Jamasi and helping to build and design teaching materials and so on. ‘Have you met Joshua, a little seven year old with a cap, steady kind eyes and probably a thumb stuck deep in his mouth?’ ‘Oh yes, do you know Joshua? What? Is he from here? He is the cutest thing! Wow is he lucky to live here with you in Nkoranza! Yes we see him a lot, he likes to run to me and put his hand in mine, we go home soon to Holland and will miss him. Yes we will take the parcel for him, of course! Vacation? Dec 10. A meeting and then the kids all depart from school.’
NOT TO FORGET! December 10! Joshua-comes-home-day. Big cross on the calendar!

The White Tornado

November 3rd, 2007

G8 weblink

From the day we returned from Israel it has been like living in a whirlwind. A superbly shining and beautifying whirlwind, which ended like a white tornado (an advertisement on TV for a washing powder that cleans whiter than white) before it fell silent the day before yesterday. I am talking about the G8, a team of eight persons who arrived at Nkoranza two weeks ago and who have returned home to Holland since this early morning, 6 am. We were amazed from beginning to end about what they did and especially how they did it. They beautified the 32 rooms where our children live. They painted, they repaired or replaced the roofing, they made shelves, chests and cupboards for each child, they extended the playgrounds, they did so much more.
How they did it? Light-footed, humorous, making each and every-one of us smile.
Their names? In alphabetical order: Ab, Abel, Anton, Bernard, Belinda, Jacky, Jacob and Mariette. A self-made branch of the World Servants.
From Holland, yes, that beautiful country where almost everything is spic and span as if a white tornado had just passed. (Or is it still?)
I had been a bit wary of their coming, thinking I wouldn’t know how to help them with nails, screws, plywood and the lot, but Baffo did it all, of course, splendidly. The results are truly amazing. Everybody had become so very happy! Look for yourself.

Bernard and Baffo, the two leaders.	On inspection tour with Peace
Placing a merry-go-round.	Painting the cuddle room
Jacky and Ab are saw-mates	New matresses for all the kids
After the White tornado	Proud to be a G8
The farewell dinner	And Charity sings them a song.

It looks like a fairy tale or as if an angel passed us by. Thank you, G8.

Vacation

October 18, 2007

It’s the last morning of our vacation. In 18 hours time, at some crazy hour after midnight, we have to climb on the plane again, back to Ghana. Last days are often ‘vacuum’ days, unreal because of the looking backwards and the looking forwards instead of the being here. Here, with the opened suitcases and heaps of dirty clothes and partly wrapped presents and souvenirs. Bob just asked me ‘what was your best day in Israel’ and I could not come up with an answer, I saw some of the best experiences passing before my eyes but could not translate them into a single best day. And you? ‘Oh, without a doubt, the day we found the dermatologist! What’s his name, Kirgily, Krigeli?’
That day was our first full day after arrival in Tel Aviv. In Ghana there is no dermatologist who has liquid nitrogen at his disposal and in Holland I hadn’t thought of it. Now these sun-damaged spots in my neck and face were growing and itching and making me nervous. Let’s do that in Israel, first thing, find a dermatologist and take them out, Bob said. So we decided to, forgetting that Israel is a foreign country where they speak a foreign language and where even the script is alien, old Hebrew revived by the pioneers who erected the State of Israel. I had a foretaste of this in Ghana when one day I was trying to google up ‘dermatologists’ or ;physicians’ in Israel on the internet. Pages after pages of what could have been doctors and their addresses in Tel Aviv, but all in Hebrew script. Nothing in English, nothing in French either. At that time I did not think of it but the experience repeated itself, not in the virtual but in the real Israel world. Telephone book? Hebrew! In the hotel, then: Where can I find a dermatologist? ‘Doctor? Sick? Come to the room? Costs 400 dollar’. Oh, no, not that sick. A skin-doctor. Skin. ‘Ah, skin, yes’. Very kind people at the desk but they look at us with a strange embarrassment and I remember that dermatologists are traditionally also the ones treating venereal diseases. I blush out of nowhere, which is what I always do anyway. All-right, there are many dermatologists in town and we get a phone number and address in Tel Aviv near to the hotel. I realize that my Dutch cell-phone does not work here and we decide to walk to his office. There is however no office at that address. There is an apartment-building with names written in Hebrew. We go to the store next door, a woman fashion-designer. She speaks wonderful French and I babble: ‘Here? Dermatologist in this building?’ She comes with us to examine all the names on the nameplates but finds no doctor among them. “Merci, Toda, Thanks. We got wrong information.’, She keeps apologizing as if it were her fault. We grab a taxi and say ‘to the hospital, please!’ For what? Asks the taxi driver, rightly. For a skin-doctor. A skin-doctor? At the emergency room? No! What do you need? We explain our case to him and he is listening as if he is a certified psychologist. ‘We got this address but there is no dermatologist and our telephone-network does not work here in Israel so we can’t check it out’. He calls the number on the little piece of paper that we received from the hotel desk. He turns to us and smiles: ‘He has left, he has moved to another place’. This man was called Ray and he saved our day! (And it rhymes so that we may forever remember Ray!) He called again to fully listen to the message on the phone and came up with a new phone-number. Shall I call him on your behalf? Yes, please, Ray, Thanks! One hand to the wheel, one hand to the mobile phone at his ear. A free flow of reassuring synagogue sound-bytes, a pen and a paper. Your name, he asks? Then he says: ‘I have made an appointment for you at 4.30, this is the address. I’ve written it down for you. He is called Kirgali, Dr. Kirgali’. He drops us at the hotel. Relieved, I go for a walk, shopping. Get cheese, olives and things like that from a local supermarket. A man comes walking at my side, talking Hebrew. Sorry I say, I don’t understand you, no Hebrew. He gives me an enormous wink and I realize he is flirting with me. This has not happened to me since I became fifty and my mouth falls open before I blush and smile and quickly walk away. I can’t find the street of our hotel back even though it is at the beach and supposed to be easy so I show the hotel-card to a woman passing by. Oh yes she says, Hayakaron, let me walk with you. Impeccable English. I teach here, art-therapy, at the university, and you? I am a tropical doctor, live in Ghana. Really, Ghana? We have a lot of Ghanaians here, football, they help us to win our football-matches! But where are you from, originally? Holland. Ah yes I thought so, I’m from Russia, I have lived here more than 40 years. ‘Like Golda Meir’, I say, whose book I’ve just read. You know her? You like here? Oh yes, I admire her. She was a strong women! Marvellous woman. ‘Listen’, she says. ‘Let me tell you something. My stepfather, the man my mother married later in life, listen what happened’, she says. We are standing still, I can see our hotel over there. ‘Listen, that man had lived in America all his life but felt so strong he had to go to Israel. It was in the time of the pioneers, you see, like Golda Meir, Ben Gurion, Peres. He eventually decided to go, he wanted his wife and children to join him but they refused and so he divorced and came to Israel alone. And he was a happy but a sad man. The children, his children, never forgave him for this. So I, when I was young, I decided to go visit them in America, to talk about how happy their father was, how absolutely at the right place he was. And how he always cried about his children. But they refused to talk to me too. Except one, the youngest daughter. The youngest then decided to come to Israel and visit her father. She rung the bell of our apartment and my stepfather opened the door. And then at once he died. At the doorstep, at that instant. A heart-attack. From joy or from surprise or maybe fear’. ‘Or all of them’, I said. ‘What a beautiful story’, I said, ‘why do you call it sad?’ ‘Because I never knew if I did the right thing convincing her to reconcile with her father and come to Israel, because see what came out of it!’
I looked at her, moved. ‘But to die from passion, certainly, most certainly is superior than living in frustration, or worse, boredom, not? I would think so!’ ‘Really’, she said, ‘I am always thinking of this’. She then said ‘My name is Hannah’. ‘I am Ineke’, I said. She kissed me on the lips and disappeared. I had wanted to call her, exchange addresses but she was right. Beautiful rare moments should remain rare moments, not to be held on to. I looked at her walking away and walked back into our hotel myself, to tell Bob about all this.
When we went to the dermatologist at 4.30 in the afternoon it was still an ordeal to find the place. He had an office in a block or a shopping mall without numbers and again only names written in Hebrew script. We asked and asked again. Finally, just in time or else our appointment would have been gone, a man who knew English and Hebrew showed us the actual office by bringing us near and then inside the door of the doctor. Till the last moment we would have missed it. Not even the letters ‘MD” or ‘Dr’on his window-pane to give us a break! But we made it and the doctor’s name was actually Krichely, David Krichely. Nice man, professional, 12 spots burned away.
So now what was my best day? For Bob and I it was the same day, our first day after arrival, the day of the dermatologist. But while Bob’s highpoint was the actual sizzling moment that David Krichely put the liquid nitrogen to my skin, for me it was meeting Hannah. Receiving her kiss. So much more, but yes, that was the moment! Now that I have identified it I can do our last shopping and continue with the suitcases!

Nana Yaw is dead, long live Nana Yaw.

4 oct 2007

Early in the morning, on Saturday September the 28th, Nana Yaw has died. Nana Yaw is often called the Chief of our community. That’s because of his name, Nana, which means ‘Chief’ or ‘Wise Man’, and also because he was the first one, fifteen years ago, to enter the then young PCC-Hand in Hand Community.
James, his caregiver, called me early that morning. Come and see please, he is behaving strangely. I went to have a look and saw that Nana Yaw, instead of eating from the porridge that James had prepared for him, looked at me with almost apologetic eyes, took another breath and…suddenly was no more. Very timidly and with a small smile, Nana Yaw had died.
The last few days he had, once again, refused all food, whatever we tried, but he had been drinking all right. We always mix his anti epileptic drugs in his food and as he did not eat that day James asked me to give his medication by injection. While I was preparing the syringe Nana Yaw started vomiting and did so substantially. So no injection at home but to the hospital, where he received an infusion together with his medications. Late at night I went to look at him there and as he was well hydrated and stable I took him back home to his room. Nana Yaw hates the hustle and bustle of the hospital and it drives him into a frenzy of anxiety. So he slept at home and the next day, definitely better, he was about to start with his porridge and then suddenly...he was no more. Gently he had gone away.

Just as gently he had put his hand in mine, fifteen years ago, when I took him away from the male ward of the psychiatric hospital and placed him in the car beside me, to drive the seven hours distance from Accra to Nkoranza. It did not bother him and he did not look back, did not look at me or at the road but looked away into unreachable distances. He was then about five years old. When we reached home in Nkoranza he at once started eating as if he was completely famished and he never stopped trying to obtain food for the next ten years or more. Only the last few years his constant yearning for food has been reduced. Maybe he was finally satisfied. In fact the last years it became increasingly hard to get him to eat anything at all, the other extreme.
I’ve seen him grow up, witnessed his first eye-contact and his first smile. I saw him for the first time climb spontaneously into someone’s lap. With a conqueror’s grin! And then quickly back off into hiding in his little room again, as if surprised by his own audacity.
He did conquer, conquered himself, his extreme fears, conquered, bit by bit, the outside world as well.

On the male ward he had been sitting on a shaky bench in between a group of similar clothed half naked adults, a small boy with his gray loincloth, thin and devastated like all of them. I would not have noticed him were it not for the social worker who had led me straight to Nana Yaw. With that same shabby loincloth he had stepped into the car, nothing else with him as I remember. Nana Yaw did not speak then, nor has he ever spoken, except for three words. He understood everything, English or Twi. If he really passionately needed something he could feel compelled to use his voice. ‘Nsu’, water, if he was very thirsty, ‘emo’, rice, if his feeling of wanting to eat was intolerable or ‘pano’, bread, if he saw bread in the kitchen or on the table. He did not articulate well and he did not speak loudly. Having to speak at all frustrated him, you could see that. Nana Yaw practiced the art of silence.
From 1993 onwards, when my house, later also Bob’s house, at the PCC Hand in Hand Community was completed, Nana Yaw has lived in his own room in that house. Always the same place, a small room with curtains and a door that he could close behind him. That is untill this Saturday the 28th. Daniel was his first caregiver, Charity his second one and Salamata his third (and longest) caregiver. Last year Alidya looked after him and when she too had to leave it was James who took over the care of Nana Yaw. They ate with him, walked with him, played with him, tried to make him enjoy the water in the swimming-pool and then there was the going to sleep and getting up and getting washed and dressed. Nana could dress himself but preferred to be pampered by his loving caregivers. For some time Nana Yaw joined the other children at Shalom special school. He would sit somewhere at the back benches and wait in silent misery till school was over. After a while the other school children began to tease him which of course we did not know.
Very early in his life the same thing had happened, small children teasing him. That happened in the orphanage where he was sent after someone found him, deserted at an empty marketplace somewhere at the end of a busy market day.
In the orphanage Nana Yaw did not behave as other children, he was like a strange bird and so he was teased. He learned to defend himself by going with his outstretched finger towards the eyes of his assaulters. That was effective to stop the children bothering him but then he himself became a perceived danger and had to be evacuated from the orphanage. And after the orphanage where can one go? The only place left would be the mental hospital and that is where he was transferred because of his ‘aggressive nature’.
Later in his life, with us while he was attending Shalom school, he remembered his ‘aggressive nature’ and learned to use his finger again in agonized self-defense. The children became scared of him and one day followed him with sticks all the way to our house. Nana Yaw was so agitated that he tore all the curtains and ripped away the mosquito nettings in his house. That’s how we found out what was going on and at once withdrew him from school, a school he should never have had to attend in the first place.

Nana Yaw did not like crowds and isolated himself at the least threat, always a threat from people, real or not. His room in the house was a safe haven that never changed.
Yet the severely autistic and epileptic Nana Yaw needed the company of people. For some time he was working in a safe corner of the sheltered workshop, helping to make curtains made from beads. They still hang in our house. But he preferred to be closer to his room. There you would more often succeed, under his conditions, sideways and without noise, to be with him and touch him. And sometimes he was so open that he would come to you, take your hand and even sometimes climb on your lap. Everything about Nana Yaw needed a manual. We all knew part of his manual by heart but unfortunately most parts were not yet explored.

After his death Baffo, Ema, James, Kwame and Osei immediately got into their action mode to do the ‘men’s work involved. Within an hour a beautiful snow white coffin was delivered to the doorsteps, a coffin with little windows and curtains behind the windows and even little Christmas-lights to decorate the interior of it! Of course they had asked Daddy Bob ‘what kind of coffin?’ and of course (for those who know Bob) he had said ‘even the most beautiful is not beautiful enough’. That’s how they had obtained this special coffin with Christmas-lights and all that. A sign of how much the boy was loved by each and all alike.
While I am writing this Nana Yaw is laying in his coffin with the little windows and curtains six feet under the earth. His body lays on a white satin pillow. Both his sides are decorated with flowers, which by now must be faded and dried, except for the paper flowers that he received as a gift from the caregivers of course. I hope he has a chance to see how extraordinary his new house is, but of course he will have other, more beautiful, things to behold than the inside of a coffin, even if it is a beautiful one. I hope so anyway.
An enormous amplifier with speaker-systems was installed and started sputtering loud high life music all over the compound, while canvas canopies went up on steel-frames against the fierce sunlight.
The women had taken the body of Nana Yaw to his own small room and washed him and prepared him to be laid in state. His face was made over with red dye for his cheecks and black for his brows. ‘Dress him like a Chief’, I asked, ‘he is one’. But the women did not wrap him in the traditional kente-cloth that I had found for him. They dressed him in radiating white clothes and admittedly he looked most wonderfully pure and gorgeous in white like that. The shape and expression of his mouth had been changed from his usual little half-smile into that of a proud warrior-like Ashanti mouth, corners deeply pressed down and lower lip protruding forwards.
Other women had already carried his bed outside and started to decorate it with white lace curtains on all sides except the front which was open.



Then he was laying there, our Nana Yaw, our Chief.

Almost immediately people started to appear and offer their condolences. I could hardly take a shower and dress let alone make my hospital-rounds. Someone else did that for me that day. People walked in and shook hands and sat down and were greeted and their hand in turn was shaken. They all came to ask in different ways if they had heard it well that our boy had left us and the answer was always yes, they heard it right. They shook their head and offered their sympathy. ‘His time has come’ a steadfast comment to console us. How did the village get to know so fast that Nana Yaw had died? (Well, of course, the digital phone plays a major part in this miracle of communication.) All our children and staff were traditionally dressed in red and black. We have been sitting there that day, shaking hands, consoling, being consoled, dancing sometimes, from nine till three in the afternoon. The Chief of Nkoranza came to offer his sympathy which was an amazing event. The Chief and Nana Yaw always had a special attraction for one another. When the Chief would come to visit us he would always first thing ask for Nana Yaw and we would then call him and see that special chemistry at work between them. Unceremoniously, in fact against all protocol, Nana Yaw at times would jump on Nana’s lap and sit there comfortable for some time to the satisfaction of both. Then, suddenly, he would be gone, retreated in his room and amazed about his own audacity! Normally Nana Yaw would never behave like that, certainly not with people he did not know real well.
This very moment a chieftaincy dispute is going on in Nkoranza during which the Chief has been advised, for his own security, not to leave his palace, till after the debate has been resolved. However, Nana did come out of his house in order to pay his last respects to his little friend Nana Yaw.



The silence was breathtaking when the Chief asked permission to see Nana Yaw before leaving, stood up, walked to where Nana Yaw was laying in state and saluted him with the V-sign, the traditional sign of respect for important people who perform important deeds in Ghana. Then he left without a word.




At three o clock that sweet man, Fr. Andy, came to perform together with Fr. Pieter the burial celebrations. Simple and moving, this part too. Singing and dancing, while father Andy gave directions to make the circle smaller, thus more intimate. A reading about a poor man Lazarus, a beggar, who died and entered heaven in order to rest at the bosom of Abraham. The rich man on earth, at whose doorsteps he squatted each day to beg for money but never got, also died but was denied access to heaven. Lazarus who pitied him but could not change his course. There was more singing and dancing around the coffin as it was carried by the caregivers into the inner circle.



The girls were standing ‘on watch’ at both sides of Nana Yaw, with candles in their hand. Then it was over and the actual burial begun. The weeping and wailing started agin, more agonized now that we were walking the remains of Nana Yaw towards the burial ground. A long line of red and black dressed people went on the small path between the guesthouses to where Araba is already buried.



Then the coffin was slowly let down into the earth and covered with handfuls of soil. Let me not write about this part, it was too passionately sad. A few persons said a few words of farewell, I too, and there was much weeping again. Sleep well, Nana Yaw. You may now go to paradise, just like that poor Lazarus. Pray that we may join you again one day.

At five in the afternoon all was over.



People however kept coming, mostly from the hospital and from the village. Almost all the ex-caregivers made it one way or another to show their care for Nana Yaw, which is so exceptional!
Salamata, who looked after Nana Yaw for more than seven years and who since last year is in training in Techiman to become a baker, had called that same morning. ‘I am coming, don’t bury him before I come’ she was crying. She was far north in Ghana visiting her mother, who happened to be ill. At once she took buses and bush-taxis, whatever she could get in order to come home in time.
In a whirl of red dust, sweat and wailing tears, she arrived too late, however. The grave had just been closed. She was joined by Alidya who, coincidence, had also been in the north with her mother, in the same town. They did not know it from each other till they called each other over the phone and then hurried down together to Nkoranza. The two were wailing so much and crying so loud that I was afraid it would hurt them. The other caregivers helped to calm them down and bring them somewhere where they could have water to drink and could relax a bit and tell each other the story. They stayed for two days. Sala and I took the opportunity to talk a bit together and it made me very proud of her. Linda too came, and Ako, and Martin and Florence and Stephen and Benson, all previous caregivers. What a family!
Now it is a few days later and we all have quieted down and started to understand that he is really gone. But often I can’t help seeing this image in my minds eye, the image of the small but royal Nana Yaw in his luxurious white coffin with windows, laying deep under the soil. His body is dead of course but he himself seems to be very present still. Then I whisper softly to him: “Nana Yaw id dead, long live Nana Yaw”.

Joshua goes to school. Does Joshua go to school?

27 sept-07

First, after the visit of the headmaster of Jamasi School for the deaf to us, it was very clear. Joshua is almost certainly deaf, and after the usual tests he is accepted to join his school in Jamasi near Kumasi. It is September and the new school-year has started, so we should do our part as quick as possible. Good news. Everybody in our community was happy for Joshua and one way or the other got involved, someone brought him new shoes for school, another one a schoolbag. Ema is Joshua’s caregiver but because Ema’s English is not so good Kwame offered to accompany Joshua to Jamasi to get the first set of tests done. Apparently that had to be done two or three times. The first test being over Kwame and Joshua came home, radiant. His hearing was tested and he is truly 100% deaf. Two weeks later, last Monday, they went again but this time returned with a lot of confused feedback. They had tested his IQ and came with a result of 50 which is too low for him to participate in school. And so…ij kreeg nieuwe kleren, een schooltas.Hij kreeg nieuwehe was diagnosed as deaf and with an intellectual handicap.



I know it is very difficult to test someone’s IQ, without having detailed information about it. But I felt very unsatisfied, of course, we all did.
How is the test done and how can they be so sure? He is an intelligent boy, at least he is socially intelligent and when he receives a certain assignment he learns to do it well, like construct a tower with blocks or push someone else’s wheelchair for him.
Of course, he has been a foundling for many years and he has lived for a long time in an orphanage where they did not know that he was deaf and so he was treated as a mentally handicapped child which often means that he was neglected and under-stimulated. Doesn’t that in itself explain that he is low in his test-results? How much practise in life did he get??
I can say all this but then who am I, a test psychologist? No. So...in limbo, what to do. We are all thinking of asking the headmaster to simply try him for a while and observe him at his school.
In the meantime a contingency plan has been conceived as well. There is another school for the deaf, in Beechem. Not too far, either. A little strange maybe to try and get him into another school, if Joshua has already been rejected by the first one? No, not at all, because a lot depends on this for Joshua himself. Is he going to learn how to read and write and communicate by sign language? Then a world will open for him! Is he going to be stuck here at a school not meant for him, the Shalom school for mentally handicapped children? Then it is likely that for the rest of his life he will learn and live below his capacity.
While I am writing this my resolve already gets stronger to bring the kid to Beechem, to accompany him there myself. Will be continued.

The Jewish New Year Celebration

19-09-2007

Nobody who has not been there for himself could imagine how touching it was, Bob celebrating his Jewish New Year with us, family and friends, staff and children (oh, and dogs and chickens of course) at our community in Nkoranza.
It was Thursday 13th of September. The celebration started at the usual hour of dusk and ended by seven or eight o’clock, which is deep in the night for us!
Apart from the children, workers and volunteers, friends like Fr. Andy, the Catholic Parish Priest, Geordie, our Peace Corps Volunteer and Osei, our ‘ambassador’ came to enrich the occasion.



Bob had selected all the readings, but because the Jewish New Year stretches over ten days not all the texts could be read, of course, in the timeframe of less than an hour. So we had to ‘prune’ the celebrations down to a few readings, songs and prayers. It felt almost like a sin to leave wonderful scripture-texts out, like the book of Jonah, readings from Hosea and Isaiah, but they had to be cut because of the children and their short attention span, and that of most adults too, of course. Osei and I helped Bob to perform this reductive surgery and when the pain caused by the cutting blade was no longer felt we all knew we had an awesome yet compact liturgy at hand.
Kwame was asked to be the narrator and the MC and he did it of course beautifully. The smaller children were allowed to sit on a blanket just in front of the candles that one by one would be lit by one of them with each successive reading, song, or prayer. James was there to see that this part of the celebration would not turn into a major bushfire!



Then the celebration opened, after Kwame’s introduction, with the ‘Shema’ sung by Bob, Osei, Kofi Asare and Ayuba.
Below is the outline that was used.

Jewish New Year Celebration at the PCC Hand in Hand Community, 2007

1. Introduction The narrator explains that we are now living in the year 5768. That the Jewish New Year celebration lasts ten days. It begins with Rosh Hashanah (means ‘head of the year’) and is followed by Yom Kippur (day of atonement). During Rosh Hashanah we remember the gracefulness of our God, as for example reflected in the readings from Isaiah and the story of the conception of Isaac and the blessing of Ishmael from Genesis. During the Yom Kippur, which follows, we atone for our sins and plead with God for forgiveness so that our name may be inscribed into the book of life for the next year.
2. Singing of Shema. (Bob, Osei, Ayuba, Asare.)



3. Blessing before the reading of the Torah (Bob)
4. Reading from Genesis 21:5-13 (Fr. Andy) followed by Torah blessing by Bob.
5. Reading from Isaiah 58:2-7 (Ema)
6. Lighting of candles (James brings one child to light a candle before each prayer) with each of the following prayers:



7. Bob sings Hatikvah
8. Adom Olam ( Fr. Andy)



9. Yigdal Ineke )



10. Meditation ( Charity- Dorcas)
11. Alenu ( Stephen)
12. Holiday Prayers ( Bob)



13. Avinu Malkenu ( Osei and Bob)



14. Rock of Ages: (Lisa)
15. Ayli Ayli (Kwame) This is the final prayer.



16. Singing Ayn-Kay-Lo-Hay-Nu (By the caregivers and Bob)



17. The end. Food, drinks, dancing. Party!

It was the children who stole our hearts and stole the ‘show’, as always.
La Shana Tova, Bob. And a Happy New Year to all our Jewish family and friends all over the world. May you and we, may all of us have a good year to come.

Autism, a picnic and our Italian friends

9-9-07

Life is not for a moment dull here in Nkoranza. For a full week we enjoyed the company of Naomi, her friend Danielle and her mother Sue Hatton. Naomi had the most original idea for a fundraiser for us; she wrote produced and directed a play –Troy- at her university in Cambridge in England. It helped the development of our community some giant steps forwards. Her mother Sue raised money in other ways and after their visit here they will surely make efforts to raise even more. But I do not want to write about people who raise money for us. Mention one and then how about all these others! No, let me write about how we enjoyed their company. How we had fun while together watching a musical on dvd, with the rain in our back and so loud on the tin roof that the musical could not be heard, just seen! The music had to be imagined and a glass of wine helped turn on our imagination. We liked the way in which Sue, Danielle and Naomi mingled with our autistic children and observed them in a playful way. That led to Sue giving the caregivers two lectures. Or let’s call them sessions. Information sharing and questions and answers, interesting, useful and stimulating. Boadu, Nana yaw, Ntiamoah, Ema, Afia, they all gained a new importance and it was as if they were aware of that. I even found Nana Yaw in our bed on Monday-night! I thought it was Bob who was pulling away my soft blanket. While pulling it back felt this unusual small hand in mine. There was light-off so it was difficult to figure out. But yes, it was Nana Yaw! Nobody else has such soft small hands. Unused hands. He left silently at dawn, back to his own room! ‘Autistic children first this week’ he must have thought! James is the self appointed leader of the ‘autistic workgroup’ and the academic and practical interest of the staff is aroused.


Teacher Sue with the caregivers

They had to leave on Monday-morning in order to see at least one or two things of the country Ghana besides us! That was the morning that two so far unknown guys, Frank and Tim, took all our staff, volunteers and kids out to a picnic at Kintampo falls. They had mailed and called if that was all right. Nowhere in the world would parents give their children away for a picnic with two unknown men but here in Ghana it is possible. And safe! By the way they were ‘Movendi-volunteers’ from the same organization that I wrote about last week. They had been teaching people how to make tricycles in Accra and their project was completed. They had heard of us. So Monday-morning came, our friends left and three busses loaded with kids, caregivers, food, drinking water, plates and cups, drums, swimming-suits and blankets also took off for the waterfalls, with loud hooting and lots of engine smoke! Who were left? Bob, Charity, Geordie and I! I danced around on an empty compound and thought of ten or twelve nice things to do to celebrate the ‘holiday’. But went to town first and there I saw a column of expensive limosines, one after another, filing into the health-center compound. I saw Osei in one of the cars. ‘What’s going on? Looks like the president is here?’ ‘No, no, come, the regional minister is dedicating a plaque. They are upgrading the health-center to a hospital. Come, join us’. The Italians too waved from their car. Somewhat hesitatingly I thought but they did wave to me to come along. As I was celebrating freedom I was in my oldest jogging outfit and so I quickly went to the hospital to inform the administrator and then went home to change and get Bob and Geordie to join me to this function. “Come, if we don’t go we’ll lose them all. Lets all go” Upgrading the health center in town to a hospital, you might ask, what are you talking about? Isn’t there a hospital in Nkoranza? How many do you need? Right! True. But…let me tell you the story. It may have been at the end of July that suddenly, after a year, Marino made his appearance again, our Italian friend who is married to a Ghanaian woman, Christina, from town here, and who comes each year from Italy to help develop the area. Marino came with a couple of Italian volunteers and lots of ‘Ciao’s and boxes with presents for the kids. He speaks no English but one of the volunteers did. So Marino told me of his plans this year. Because he was offended by the Catholic Hospital he had decided to build another hospital just behind his house in Nkoranza. The volunteers were building it and already had reached roofing level. ‘What?’ Yes, a hospital. Sounded to me like that short time in history when there was a Pope and at the same time a ‘Counter-Pope’, elected by angry people who despised the ruling Pope. ‘Oh’. Yes, they had offered our hospital a helping hand, offered to build a new ward for the hospital, but the diocese in Sunyani had subsequently increased the estimated money so much so that the Italians had withdrawn, angrily, offended that their help was not appreciated. Bad chapter in Hospital policy, this is not the way to maintain your benefactors. But a new hospital? Wow. ‘Are you sure? How will you get a doctor?’ Oh no problem. Nothing any problem. Arrivederci. Come eat with us! We have nice wine, from the region. Lambrusco, you know. Come! Bob went to eat with them later, Bob and Marino are very cordial together and friendship is friendship, needs to be cherished. I didn’t go, didn’t want to see that new structure behind their house. The ‘counter-hospital’. Was stupefied about this duplication of buildings and God knows maybe even services if they would make it that far. I was worried about an obvious stupidity of some of our hospital policy-makers but more so over all kinds of money being wasted in impossible projects. Four weeks later, Sunday-morning. I’m ready to go for rounds and who is there, sitting in front of our house? Marino with three Italian doctors. From a humanitarian doctor’s organization of which I have forgotten its name. One is a professor in Obstetrics, from Milano, I believe. Thank God one of them speaks some English. He has the dictionary opened on his legs and consults it constantly while he is addressing me. This does not speed up the conversation and I make clear I really have to start my rounds in the hospital. They give no sign of understanding, I resign and sit. They explain extensively about their organization, meant to train doctors in developing countries. The professor, who looks like a professor, with his white mane of hair, nods benevolently. He is the boss. ‘Great’, I say. They tell me that the next day they will go to the regional Health Directorate in Sunyani to talk about their new hospital. Do I know a doctor, a nurse, someone for their lab. How to go about it, please. I am their sister and the only one who can help them. Because of Marino I am polite. Do they know that a hospital needs to fit in a general health-plan? That if it fits it has to be inspected and approved before it can operate? That a doctor is almost impossible to keep in these rural areas? At our hospital, so let alone in a small clinic? That the doctors prefer to work in larger cities. That their salary is substantial? That that of a qualified nurse is not peanuts either? That here in Ghana there is a well developed infrastructure, that this country is not Chad or Mauritania. (Hope I did not insult those two countries for I don’t know their infrastructure really well!). Did they make a budget? It would be much more money equipping and maintaining the staff than it would be to build the building. That yes it is great to train doctors but did they know that doctors need to be licensed in Ghana before they can work here? I must have discouraged them for they left in a bit of a flutter. I ask Bob, ‘Did I sound angry’? Yes, said Bob. You always sound the way you feel. Oh, sorry, I had not wanted to shame Marino. Monday and Tuesday went by, other things happened. It was Wednesday morning and I went to our weekly doctors meeting. Did I hear already that there are Italians who are upgrading the health center in town to a hospital? Do I know that the town is divided and completely engrossed in this matter? That some, most, are elated that ‘the monopoly of the catholic hospital’ is over and there will be competition in the future? I say ‘what’? ‘My knowledge goes no further then that behind their house they are building a hospital which probably in future may function as a maternity home or clinic. What is that with the health-center? Three hospitals, then??’ After the meeting I go to the administrator and ask her about this newest news, about upgrading the health-center to a hospital. I tell her what I know. She is so very furious with the person who has, a year ago, swollen up the initial budget to impossible heights that everything else escapes her. She is on the phone, to talk to the vicar general, the bishop and the nun in Sunyani who handles ‘health-issues’ on behalf of the hospital. Wait she says, stay with me, they should hear this! I wait. None of the lines are responding, one even has an answering machine, novelty for Ghana. “I cannot come to the phone right now, etc.” Cool down, sister, relax. Yes, absolutely, this is not a good way to treat your benefactors! Then this Monday, the line of expensive limousines, the function at the health-center. So…it is true!! Bob has dressed up in long pants, I wear a neat kind of jacket. Here in Ghana we like to dress up for functions like this. So our dented old car turns and parks where the limousines are standing and in Ghana style we are announced upon arrival over the speaker system. “Here is Doctor Bosman from the health-insurance! And her husband Dr. Bob.” Poor Geordie is not taken notice of. We are seated at the high table and for a moment the administrator joins us, but then she has to move on to Sunyani, still on her witch-hunt for the person responsible for the goof up. The Italians look hesitatingly at us, trying to find their balance between ignoring and smiling (their more natural way). We do the same. They must know by now that I understand their anger but that I look down on their impulsive actions. That I might think of them as ignorant, strange and somewhat inflated birds. Well. I hear the DCE, the mayor of our town, give a speech the kind of which I think no leader should give. He speaks about the greed of St Theresa Hospital and the ‘Catholic System’. “The monopoly of the catholic hospital will now be broken.” Miserable public rebel rouser! I make a mental note to one day attack him about this speech in his luxurious air-conditioned office with leather chairs and what not. Talking about greed! Then it is the turn of the regional minister. He does better. He says Nkoranza always has pleasant surprises. The Catholic Church here has given us a hospital and health-insurance. And now the Italian (what’s the name) has come to train our doctors and to upgrade a ward at the health-center. Then the Italian professor talks and then Marino talks. Christine, Marino’s wife, translates it straight from Italian into Twi. Bob has already gone home because of the heat but I want to stay and talk to the Italians. I manage to work myself to the side of the Italian doctor with the dictionary. ‘Can I talk to you?’ ‘But of course, doctor Bozzzman, of course.


’ But of course doctor Bozzzman.

Listen, I don’t know how many clinics you want to build. The more the better, maybe. Or maybe not. But why not stop with the anger now and help us as well. You know when it comes to complications, operations, Caesarian Sections, the women eventually all come to our hospital. So please keep helping us. Look your organization wants to train doctors? But you have to train them in hospitals, and ours is the only hospital. So please don’t scatter your efforts too much. We need you, for example to upgrade our operation room. We need instruments. Badly! You don’t trust the Catholics? Fine. Lay new operation room instruments in my hand and I will put them where they belong. And count them every day, if you want me too’. He starts laughing. “Oh Doctor Bozzzman, of course we will help you, we love to help your hospital! How is Bob?’ Marino sees us and is so relieved to see us laughing that he runs to us on his short legs and starts embracing me. Bacchio! Bacchio!, sounds like what he says. Public kissing, how un-Ghanaian but everyone bursts out in laughter. Ghanaians may not like public display of emotions but they love reconciliations! With red cheeks I go home…just in time to see the large busses return with our kids. Satisfied, tired. Much can happen in a small dusty town in Ghana in just one day! Not so?

Emmanuelle

Sept 3, 2007

Emmanuelle will soon to be three years old. She is becoming beautiful in a quiet and slightly melancholic way. She talks a little and smiles a lot. This Sunday morning she should have been making the headlines of the paper with breaking news of great importance: She has understood how to suck lemonade from a straw! Independently!

Joyce, her caregiver, and John, her big brother, pamper her as if she is still a baby. And why not. I would definitively pamper her too. It’s hard to see a girl, who has so much undeserved misfortune in her life already, cry because of the discipline needed to teach her new things. So if the caregivers or volunteers try out a new way of helping her to become more independent, she has to be stolen away from Joyce, John and probably myself.
Movendi did just that. The movendi group, that I have been meaning to write about sooner had not other issues got in between, has done a lot of good for our kids. They designed a chair for her, a heavy chair that could not topple over, and Emmanuelle was to sit on that chair, in a kind of safety belt, and learn how to balance her body, how to swing left and right, back and front, without losing her balance or even being afraid of that. Now it is almost a year after that chair was first introduced. Oh did Joyce hate that chair for her baby! If Emmanuelle would be seated in it and the seatbelt would be closed she would start crying, weeping, hollering for fear of falling. Joyce would look at the volunteers and the physeo-group with desperate eyes. ‘Stop teasing my child’ her eyes would say. When the last Movendi volunteers, Marije, Annemiek and Piet left, they expressed doubt that the chair would still be used. I doubted it too. Wrong!
With a combination of tact towards Joyce and unusual persistence despite Emmanuelle’s crying the caregivers practiced every morning at the physeo-hour. A day, unnoticed except by only a few, the crying stopped. Another day, smiling started. Yet another day, we saw John playing with her giving her a balloon to hold in her mouth.

And then yesterday. A miracle. Philo saw to it that Emmanuelle was drinking her milk from a straw!
You notice on the picture that the chair has got an extension: a table that can neatly slide up and down to different levels of height. For playing. For drinking. For trying to draw with a pencil held in her mouth. Who made that extension? Our ‘local’ Movendi’s: Jerry and Ameyaw Hayford. Who taught Emmanuelle to use her mouth to hold a pencil (or a straw)? Caregiver Stephen and volunteer Lena, during their daily the speech classes. Who loves it all, now that the pain is over and the smiling starts: Emmanuelle. And then Joyce and John and Ineke and Bob and all the rest!
They did more, the Movendi volunteers. Much more. In the beginning when four volunteers came at the same time, it was such a tiring hustle and bustle, understanding their expectations, giving some of our expectations, listening to the expectations of the caregivers. It was an overwhelming group in numbers and a difficult start. But all is well that ends well. Lets see them exercise:

Aaron is resting after balancing on the ball


Wumpini actually somehow manages to stand up straight


Kwame helps PaaYaw to do a balancing act


And Mr. Ameyaw keeps building
tricycles for handicapped people in
Town. Great service to our people.

Thank you Movendi-volunteers, once again! It works, you see! So thank you very much.

Old Hands and Young Rebels

Aug. 26 2007

I hadn’t finished writing the previous column or another surprise awaited me on Sunday night, which I must write about. Sunday after supper there was, as usual, a meeting of all caregivers. If I could be there to give them a word of advice. What advice? To respect each other. Not to talk too much. I had of late also noticed a certain strained atmosphere and knew it was good to attend the meeting but that night I absolutely did not feel like it. It was also the last evening of Marieke’s visit. She is a volunteer from 5 years ago who had spent the whole weekend here and would leave on Monday-morning. I had wanted to be with her. Anyway, I went to the meeting, only for ‘five minutes’. It took place at a (for me) new venue, the disco-hall. That is a big summer hut where on Saturdays we have disco with the children. It’s a good place for that, not for meetings. In the dark I could hardly discern the twenty-two faces. The circle was way too big and the one forty watt light bulb could just about shine a weak glimmer on the floor beneath it, everything else was left in the shadows. The caregivers already assembled when I came were hanging, leaning over, yawning and sticking out their legs so far in front of them that they might have slided out of their chairs. Some were making mobile phone calls. You would hear all kinds of ringing tones, Nokia tunes and the more fashionable versions downloaded on their phones from the internet café. Conversations rumbled on in the dark. Some people were so much turned away from one another that they could not see each others expressions. It looked like youth hanging out at certain street corners in big cities. Exaggerated maybe, but very unpleasant all the same.
Eventually most were there, the phones were hidden in pockets and it became quiet. Hello, I said. I would like to be with you tonight, it has been a long time ago. (Too long, I thought.) I would like to say a few things. Then if you want, time for questions. Followed by your own meeting as usual. The silence deepened so I just jumped in and started to talk.
‘Yesterday. Another party. We waved goodbye to Alidya. You saw how many outside visitors there were. That happens more and more, we are getting a name. Good for us. Yesterday these visitors posed good questions to us. And always, always, I am full of praise about you and say so to them. Yesterday too. I said: ‘without the caregivers this whole community would sink like a leaking ship. They are at the center of it all. You are. And thank you for that.
You know and then I meet you here. I see you tonight. Forgive my words but I see you here in semi darkness and you look as if you are absolutely not interested in…anything at all! You hang in your chairs, make phone calls, walk in and out as if this meeting means nothing to you. Then I think this: Am I, Ineke, living in a dream world, a world of make belief? Are you really the spine of the community or am I just saying that because I would like it to be so?
In the meantime everybody is sitting upright, almost open mouthed. Theya re not used to this. Okay, you look better already, thank you! Yes, you are the center and the spine of our work, the care for the children. When you are kind with each other there is a great spirit here and the kids and all of us feel that. You know that yourself. When there is someone who looks bored, is upset, gossips, is arrogant, then the atmosphere changes immediately and we all become upset. People nod, it is true.
I would like so much, I said, for people here to respect one another. Respect from the youth to the older ones. And the other way around. Just like you are used to, here in Ghana. Imagine you have a certain family. The parents are poor, did not have a chance to go to school themselves. Imagine they are real good people and they say to each other ‘Our children should not grow up the way we did. Whatever it costs us, let’s send them to school, let’s see that they get an education and a chance in life’. In Ghana that is happening every day. What would a child say to a parent when he gets such a chance ‘I’m proud of you’ or ‘Thank you Dad, thank you Mum’ That happens a lot, but maybe not enough. An increasing number of lucky kids who have left school think like this: ’My parents. Ah, they don’t even read the paper.’ ‘They are boring and all they care for is their church.’ ‘Know nothing of the world.’’ ‘ I am ashamed of them’ ‘They don’t understand me!’ Maybe they don’t say it out loud but you can hear them think like that.
Does that sound familiar? Would you ever do that?
Of course not, not you, but still.
I have noticed that within our large family two groups are developing. The young secondary school leavers who ask to work here for a year or two before they move on and the others who did not have the chance to learn much by way of going to school. But were maybe able to send their children to school, or hope to do so when they start a family.
Who do you respect more? Those with a good education or those that would like to have one but could not. That is a question. That is my question to you.
Oh Maame, we respect those who sacrifice for others, not the pompous ones. Those that sacrifice are like our parents, those we respect. Remember we are Ghanaians. So do not ask that question. Lack of respect is a problem of your world in the West, not of our world. We know how to behave.
Oh great, thanks. Well remember this tonight during your meeting. And tomorrow if the one who is in charge of you asks you to do this or that. Thank you. I am glad my advice does not concern you.
Time for questions. Three fingers shoot in the air.
‘May I know if Ema is staying here? Will they help us, or will he leave again? May I know what his position is. It is not clear to me.’ Arrogant young voice. ‘Not only has Ema resumed duty on a permanent basis, not only is he coming to help us, but you are going to help him, he is your boss. You must know that, for he was twice introduced as such. Next question’‘My question is this: Isn’t it the task of the management to give us contract letters after the three months probation-time is over? I am here for over three months but no-one has given me a letter as yet.’ The young boy who is waiting for further education and is a little rebel-rouser, the lawyer for his peers. Answer. Next question.
‘My question is this: have they told you about the issue around the caregiver of Quinten, for we have now discussed it three times. No-one takes any steps.’ This one wants to hurt Kwaku, the intermediate leader and reporter to me. Answer
The fingers of the same three are already waving high up again. Anybody else? No? Okay, you: “So many times did we talk in meetings about Boadu. This and that. Boadu does not smile, Boadu does not eat. After all these meetings Boadu is not one step further. How many times should we meet?’ the arrogant one. Answer. Next question, yes? ‘Why don’t we all receive light from the generator when town-light is switched off. Some get, others don’t. Are we not all equal or do you not see us as all equal beings?’ The voice of the peer-group lawyer again.
This way it continues till the questions dry up. I thank them and go home while they continue their meeting. The tone has upset me and I cannot sleep well that night. Monday I am still thinking about it and sit quietly somewhere digesting the mood of the previous night.


One of Baffo’s New Style Tables

Monday afternoon Kwaku, Ema and myself decide to sit down and talk about the Sunday meeting. We sit around the table, one of the new tables that are designed by Baffo. Beautiful and useful for everything but especially to meet.
How long is this already going on, Kwaku? It looks like a bit of a revolt of the young against people like you, Joyce, Angela and Ema, our local leaders. You can always expect to be criticised when you are in charge, that is in the nature of things. But as much as yesterday evening? There must be a small group that agitates and pulls some others along.
Kwaku is relieved that the subject is discussed that he mentions all earlier insults, some very personal to him. It’s hard to believe. They make noise when Kwaku says something, they giggle and crack jokes so that at times it is impossible for Kwaku or Joyce to talk. Sometimes they receive an arrogant shower of questions that they don’t understand as it is in English. They have been pushed into a state of defence.
Why? Kwaku laughs. Ema smiles. The Ghanaian answer. Ema is more verbal than Kwaku but he is just back and has not been at all of the meetings. Ema, the guy who asked me that question, do you think he really does not know that you are back and that you are the coordinator?
‘Oh, yes, he know that.’
When did all this start. About a month ago. One evening they realised that the old meeting place had become too small, so they moved to the disco hall. In fact discord started in the disco hall.
Yes, only two or three persons who make meetings difficult. The lives of the local leaders, Joyce, Kwaku en Angela, unpleasant. Some others are just weak and let themselves be influenced.
Before we knew it Kwaku, Ema and I were making plans on how to divide the large group into three smaller ones. No more meetings in that crazy disco with those young rebels around. Group one, leftwing, left of the kitchen, all caregivers who live on the left of Janet’s kitchen. Seven caregivers. Who lives right of the kitchen. Eight? Great. How many caregivers at the workshop, in all? Eight! My God. Done! We have done it. We have a new table- and meeting-arrangment!


New Style Meeting-arrangments

A group of seven, eight persons, then you can talk again! We had found the solution. From a sleepless night (mine) and a miserable month (Kwaku’s) to the birth of a new style that was more than worth the trouble.
Tuesday. I talked with the young rebels, one by one. They compleeeeetely didn’t mean it like that. Was that my impression of them? Yes, be careful of what you say, how you act. Don’t. Don’t stage for trouble. You energy can be used better, much better than that.
Wednesday: A meeting without an end to it. Kwaku and Ema wanted us to meet that day with all the caregivers, one by one, and in the presence of Joyce and Angela as well, so that all would know who were the bosses. To tell them about new style meetings and ask them how they feel about this. We did. Started at 10am, completed at 3 pm.


”Gifty, how would you like it if...”

We sat there. We let one after the next come and sit with us. We alternated being the spokesman. And the enthousiam was great, and authentic, and immediate. Yes!!!
Small groups of seven or eight. That we can handle. That we like. Then we can talk again. Do we have twenty four caregivers now almost? Yes the last few meetings were bad, always time was over before we really came down to the issue of the children. Great, then we can start again, we can move on.
The three groups are divided in such a way that Angela, Joyce and Kwaku are each the leader of one group. Ema will be the one they report to, he will circulate from one group to another. The ‘rebels’ are separated over different tables. All these arrangements came so spontaneously, just by counting the persons on the right and on the left of the kitchen.
That’s how out of a bad night a new and good idea was born!
Thursday and Friday I was sick. Maybe the excitement. Maybe the fact that some of our best volunteers are leaving tomorrow and next week. Maybe the cause is as simple as a mosquito bite! By the way to be mildly sick is a wonderful way to rest.

Thanks.

August19th

It’s Sunday afternoon and I’m just back from the hospital chapel, where I attended the Thanks- giving service at Nkoranza for the life of Kwaku Adyei, the young nurse who died four weeks ago. His parents had come all the way from Berekum for this Mass and so the chapel was filled to capacity and over with people dressed in white, the workers of St Theresa Hospital. At the end of Mass the father of Kwaku gave a small word of thanks for the life of his son. Like a flower he said, an exceptional beautiful flower, put on the center table where all people could enjoy his skills and his beauty and his zest for life. And then by accident someone knocks over the vase and the flower dies. Just like that. Not God’s fault, not the fault of people, it just happens. Who are we to want to understand the cause of living and of dieing.
It’s a strong and gentle man, in his sixties, muscular upper arm on one side, white cloth over the shoulder on the other side. Stately and solemn. Uses words like a poet. I know him, vaguely. When as a young tropical doctor I worked at Berekum Hospital in the seventies, he was there as a new hand in the hospital pharmacy. His wife who is the head of the maternity department at Berekum I missed. She arrived as a young trainee in 79, when I had just left berekum hospital for another place.
When his words of gratefulness for his son’s life are over, he gives a bundle of money to the hospital chaplain. “Please. This amount is meant to buy chairs for the chapel. So that our Kwaku can come and sit here at any time.”
Beautiful, I get tears in my eyes.

Alidya, our caregiver who leaves next week, Alidya had tears in her eyes yesterday at her farewell party. (The party was well attended not only by our children and staff but by a large number of cheerful visitors from Holland, our Italian friends and a number of other visitors but it was ‘Alidya’s party’.) So yesterday-evening was Alidya’s evening and after the start of the party I took her hand and brought her inside the circle of children caregivers and visitors to thank her. I said something about her extraordinary humbleness and about her love for the children. How bad it will be to have to miss her in the future. How well she looked after Nana Yaw, about whom everybody worried so much after Sala’s departure, when we all thought he would completely refuse to eat from then onwards. The opposite happened.
Alidya is leaving because her mother has called her to come home and help her. Her home is far away, in the north of Ghana. Poor Alidya. Yesterday she started to give a word of thanks but her voice broke while tears were rolling over her cheeks.
Such an unassuming person. But one of these persons on whom the community and the wellbeing of the children depends. Bob has just started to teach her and a few other caregivers to read and write. Complete with schoolbooks, pens exercise-books and a lot of fun of course. That too she will miss, is what she tried to say between her tears. And the children, oh, the children. Her words were inaudible and her tears kept welling up. I am amazed at my own ignorance about the depth of this woman. To notice that only at the moment someone is leaving after four whole years, I felt ashamed.


Alidya with nana Yaw who is going to miss her.

‘Alidja, Thank you. And do come back, remember! Just like everybody else of this large family you should come back at some time. Always welcome, always a place for you, visiting or wanting to come back to work, whatever’.

Talking about returning! It was in July that Ema and James completed their ward-assistant course at Dormaa Ahenkro. They returned to our community to plan from here how to write solicitation letters for a job as a ward assistant at the hospital. Both felt homesick for the kids and for the special atmosphere of our place. They talked about ‘coming home’ which was so good to hear. From the PCC/Hand in Hand community as a base they wrote their letters to the hospital, with a recommendation letter from me, of course. All this after studying the situation on how best to get a positive result, for all hospitals have a ban on employing new staff and we know that most course attendants remain unemployed afterward attending this course. Rather soon I got a positive sign from the matron of the hospital, things might be moving well for Ema. A certain ward assistant was transferred to another hospital so there would be a vacancy in the near future and maybe…That was such good luck and Ema was fully surprised with his quick success and so very grateful. James you have to wait a bit longer poor guy, but there is hope for you too.
Soon the day came that Ema, in new khaki-white uniform and with polished shoes, walked up the hill for his first working day at the hospital. Nervous of course. Now he is a success, already. I mean he is a born caregiver!
During the days before that big day, however, a lot of conversations took place. Ema, when you get a job here in the hospital, where are you going to live? I don’t know, have to find a room somewhere. And your wife? Oh no, she is settled in her new trade, she is staying in Techiman now. Oh okay. The old Ghanaian way then. Man and wife happily independent, visit once in a while. So if you get chance to work at the hospital would you like to have a bed here, at the PCC here? Would you like that? Oh yes, that I would like! His eyes beamed. And Ema, I have two jobs, the hospital and the kids here. How about you? Would you like to work here again as well? Offer a helping hand with the coordination again? I mean if I can handle two jobs why not you, how would that be? Yes, Maame, thank you! Immediate, direct, heartfelt.


Ema is back as coordinator

And so it happened that Ema is now a ward assistant and a coordinator for the PCC Hand in hand community as well. All within a few weeks. He silently returned, through the backdoor of the place he loved so much. Different from the way we planned but very good. Good for him, good for his wife, good for us. Immediately after his ‘Oh yes thank you’ he was asked to help coordinating the workshop and he did. The problem there was that the caregivers tended to concentrate on the beautiful products to be made and had less time for helping the children. This has always been the problem and more so after the departure of Ellen. Angela is a good woman but not necessary a good leader and it was all getting too much for her. So, all heads together, and what happened was radical redistribution of caregivers from table to table. One caregiver per table of 4 or 5 kids. It started to work better. Not perfect, but better. Then the games and plays at the daycare programs. Same thing. The indivisual care for each child, improving. One by one, slow and systematic, Ema goes fo it. Task description volunteers, Ema can help because he has such intimate knowledge of the children and the toys we have and a memory for all that was ever tried by anyone, successfully or unsuccessfully. Ema is made to do this work as well as being a nurse.


Physeotherapy hour in the morning

The physeotherapy, marvellous! Ema was the leader of the group trained by the Movendi volunteers and he was the best. And then he left. Woops. And suddenly he returned again, woow! When Ema runs shifts from 8 till 2 he spends the afternoon with programs such as speech classes and the swimming hour where you see him observing and interacting. When he runs afternoon shifts he is the first one to appear at the physeo-hour at seven in the morning. His favorite place! When he has night duty, like now, you see him sit with caregivers in the morning or late in the afternoon, and you know he is talking about the children and the personal life of the caregiver as well. Problem situations to solve or just to be able to talk about. Ema is there. Like Alidya who has to leave because her mother wants her at home with her. I bet that Ema has the full version of Alidya’s story.
He is back. Thanks! For life and for the bit of dying that is part of it, for coming and going, thanks for all that is part of life. Who are we to try and control or understand all of it? As Kwaku’s father said this morning in the chapel.

Kwaku’s Funeral

12th august

One early morning, three weeks ago, Kwaku Adyei Djan, a young nurse from our hospital was found dead on the road to Techiman. His crumpled up motorbike was laying beside him in the ditch. Over speeding, they said, those nurses who knew him well. Kwaku was a popular guy and a good nurse who was known all over town and beyond. After the shock the grieving started, immediately. Hospital staff was standing in small groups in front of the hospital, talking and repeating many times in different words what they knew about the accident. Who saw him first. If he wore a helmet. How he was transported to the mortuary. With a certain restrained pride they talked about his fine character and his only vice: riding too fast on that bike. About his parents who had done their utmost to give their son a good education and career,.and now this. For three weeks the nurses wore red ribbons around their wrist, the Ghanaian sign for mourning the dead.


Kwaku homecall

Kwaku’s family decided that this weekend the funeral would take place. A bit of a funeral in Ghana must last at least two nights and three days.
So the administration of our hospital had organized transport for whoever wanted to attend. Friday night late I saw many of them already gathered near the cars, dancing and singing and working themselves up into a funeral mood. At 2 am the column would slowly drive in procession to Berekum, the hometown of the nurse, with the car containing Kwaku’s dead body driving solemnly ahead of the other cars. I experienced a certain togetherness as if the people were already intoxicated with the coming event. Some people of course were simply intoxicated by a few drinks but the general mood was solemn and passionately sad. Like black velvet.
What an event. At predawn the body would have been off-loaded, the face made up and the remains of Kwaku would ‘lay in state’ in the coffin on a large bed at the funeral grounds. To receive the last wailing farewells of friend, family, colleagues and strangers alike. Then during the course of the morning the coffin would be closed and carried to the burial grounds and sunk into the freshly gaping hole in the ground. The last desperate howling would be heard, from his closest ones ‘Kwaku. No. Come back!’ ‘Don’t leave us, man!’ ‘Come, sweet boy, come drink my breast again’ ‘Return, Kwaku, return at once to your mother’.
After that, the funeral celebration would start, a Ghanaian version of a reception, with many, many folks sitting in a big square under canapés to provide shade and either shaking hands or being greeted with a handshake. All will be dressed in red and black cloth. The emotions would now be contained. Groups of people arrive, are announced, walk from person to person, greeting them till they arrive at the family of the bereaved, then the greeting gets more deliberate, slow, solemn. In the quality of the handshake, the eye that meets an eye and the mumbled words the depth of empathy is expressed. They move on and are seated somewhere. Then the family gets up and welcomes the delegation that has just arrived with a handshake in return. The importance of a funeral can be measured by the number of hands shaken. Drink will flow and the eyes may turn red but the atmosphere usually remains solemn. (Unless a hidden grudge has chance to explode or ‘someone turned mad’) . As night falls the people gradually disappear to show up the next day again in white, for a church celebration. The service is called thanksgiving service and transports the funeral to a higher plane. That’s it. Then all go home and have a good rest.
I was not there but I am convinced that this funeral was one of the larger ones. A bittersweet one that will be long remembered because of who he was and how young he was.
I was not there, I was here, in Nkoranza, and as usual I was on call during the weekend.
Friday night there was urgent need to a C-section and I encountered the anesthetist and operation room nurse among the mourners outside, with the cars. We all worked together as usual, professional, swift, gentle and silent. Nice big buck of a baby, crying to the relief of the mother on the operation-room table. I ask the anesthetist. When you go at two am, who shall I call? ‘Oh, there is a skeleton staff left behind here, doc, so call them’. Okay, give my condolences to the family and go slow. We don’t need more funerals now.
I go home to sleep. Next morning, yesterday, early rounds. No problems on the wards. Then maternity. Two women in need of a Caesarian section. I call the other anesthetist but the phone does not answer. One of the women needs the section urgently. I check the house of the other anesthetist. No, he has traveled to the north. Nobody home. ‘Oh God, there we go…’ We arrange a car and refer the two women to the nearest hospital, which is Techiman. The car takes the same road where the nurse had his accident.
I get to the emergency room and find a man who is vomiting blood. Large gulps of blood, an emergency. Blood please. I go to the lab. It is closed. Where are they, those on call? To the funeral. I start loosing my temper even though that is ‘not done’ in Ghana. The team in the emergency room consists of to student-nurses and a nursing-aid. They sit and look at me, not understanding why I am upset. Turn that radio off, I say. Who is in charge here? The nursing-aid is very shy because she is only an aid and does not dare to say she is in chare in front of two students who later will be qualified nurses, a state she will never reach. ‘Who?’ I ask. ‘I, Maame.’ ‘Okay, good, why not send the watchman to the houses of all the laboratory workers and find someone. This is a life at stake. A life. He needs blood, needs it now.’ ‘Yes Maame, yes.’
I see the other patients and go home to eat. Return at 5 pm. See the same patient laying on the same bed, card missing, no IV, no blood, nothing done. I get furious. I send him to the ward and wait till I see that at least an IV is set up. I call the hospital-driver who is at the funeral. ‘Funeral people please what time are you coming home?’ ‘Doc, we are coming, we are on the road.’
I check late at night. The man has got one miserable pint of blood and is still in shock. ‘Four please, at least four, fast, please’, to the nurses. Sunday, today. I fear making rounds though nobody has called me during the night, which means either the patient is dead or he is stable. He is there! Kind of stable. Still only got one pint but his hemoglobin is tested. Shows a number 3 which is 25% of what he should have. I think of referring him to Techiman hospital but that is a scary thing to do. The humps and bumps in the road may make him bleed again. Lo and behold the lab is open and the technician is back from the funeral! Steve, please, that patient needs 4 units, at least, please try! ‘Oh I got him one when we returned yesterday’, says Steve with professional pride. ‘I know, thanks, but that is not enough. Please urgent. By the way who was to have stayed behind yesterday, when you were at the funeral?’ ‘Oh yes we always cover our department’, he says with a frown to me. How can I doubt the credibility of their laboratory efficiency!
I stop there but have something to sort out tomorrow morning when all are hopefully on post again. It will be an unpleasant meeting. Skeleton staff? My foot! I might as well have gone myself, to the funeral. What good is someone like me without a lab, without a good nurse, without an operation-room.
Beyond the frustration of a doctor who is powerless there is a larger problem: this funeral might have caused or may cause three other deaths, three other funerals, because of omission of good care at the hospital. And if one funeral can breed three other funerals, how many funerals does that make in, say, one year?
‘Kwaku, my dear friend who passed away, can you hear me? Did you see what happened at Nkoranza? It’s because your friends loved you so much that they wept with you and came collectively to do you right. What do you say? Did they do right to you if that means doing harm to patients? You are above it now so try to tell us, please’

Archief Ineke's colum dec 2006 tot July 26th 2007

Archief Ineke's colum may 19 2006 tot december 20th 2006

Archief Ineke's colum June 2005 to may 10th 2006