Land of the Lumps

Hello! I hope you are all well and happy as the month of June comes to a close.

Updates from Ghana: we just finished our surveying in the mining community today, and tomorrow we will move to our control community (where there is no gold mining).

It was sad to leave Kejetia because we’ve made some good friends along the way. The carpenter’s wife, named Love (isn’t that adorable?--Love), was particularly sad today. She has a particular attachment to Rachel, and she bought “Maltas” (a malt drink) for Rachel and Kaylee and copied all of Rachel’s contact information. We have also grown attached to the kids in Kejetia. Gifty, Tina, and Theresa play follow-the-leader and do the chicken dance with me. They also delight in carrying our backpacks and equipment around the mining site (oh no, I’m exposing the unethical use of child labor in this study!) A little boy, named Calvin, hangs out with us almost every day. He holds three of my fingers in his little 4-year-old hand as we walk around the community searching for households to survey. We also hang out with Calvin’s buddy, Junior. We call Junior “Baby Driver” because one day when Allison finished her survey early, he climbed into our van with her and sat right in the driver’s seat pretending to steer the van! (I sing Simon and Garfunkel to him often: “…they call me baby driver, and once upon a pair of wheels, hit the road and I’m go-o-one…”) Allison, Mozhgon, and Kaylee have provided ample “toffees” (candy) to the kids throughout our visits, and this last week Allison also gave out stickers, silly-band-bracelets, and star-shaped sunglasses (priceless pictures!).

The Survey:

I realized that I never really explained what “surveying” entails… here’s the gist of a day in Kejetia: First, we split into 3 groups and each group locates a random household to survey (we use a GPS maps that we constructed when we arrived in May of all of the household structures in the Kejetia to select random houses). We often traipse to several households before we find one where the inhabitants are both home and not too busy working. Once we find willing participants, the survey begins.

“The survey” comprises four smaller surveys: a household, occupational, malaria, and diet-and-nutrition survey. We start with the household survey to obtain a record of the full names, ages, education levels, and occupations of all of the adults in the household. We define a “household” as all people who eat from the same pot. Households in Kejetia vary widely in structure. Today I interviewed a wife and husband with their 9-month-old baby, but I’ve also interviewed a household with 10 adult men, who all crush rock, and a household with 5 adult women with a slew of children, who cook and sell food in Kejetia.

After the household survey, we conduct up to 4 occupational surveys per household (depending on how many adults live there and/or how many adults are available and willing to participate). The occupational survey is by far the most time consuming because it includes lengthy questions about work and health history. In addition, we take biological samples of participants’ hair and urine, measure blood pressure, and lung health during this survey. We measure lung health with little machines called “spirometers.” Throughout our 54 surveys in Kejetia, our translators and us girls have become pros at the spirometry technique. We always elicit laughter and Fra Fra jeers as we demonstrate: “Blow out as FAST, HARD, and LONG as you can!” It’s fun to have a good laugh every day. :)

When the occupational surveys are all done, we continue the other two surveys with the household head. The malaria survey attempts to understand how well people understand the cause of malaria (i.e. mosquitoes), symptoms (fever, vomiting, headache, shivering, body convulsions, and diarrhea—if you weren’t aware; I didn’t know before, but I have them memorized now), and how people treat malaria when they contract it (go to a clinic or take medications, etc). I know malaria sounds scary; I always cringed at the thought when I heard statistics back in Michigan. Malaria is so common here, however, it’s regarded more like the flu than some deathly disease. Most Ghanaians have malaria several times throughout their lives; it’s just a fact of life.*

The final survey about diet and nutrition is the shortest of the 4. We ask about foods/beverages that participants have consumed in the last 24 hours. Luckily Ghanaian cuisine is rather limited; everyone eats banku (or some type of lump)**, goat meat, dried fish, a leafy green (called bitto) and maybe some shea fruits.

We conclude the surveys by compensating each participant with 8 Ghana cedis (which is about 6 US dollars). We also ask if our participants have any questions , comments, or suggestions for us. Almost everyone asks us if we will give them medications. To this we have to answer: “Sorry, but we are not doctors, so we cannot diagnose what’s wrong or prescribe drugs. We will bring back your results next summer, and we can make suggestions then of whether you need to go to a doctor…” It feels a little dissatisfying. I wish we could offer more tangible and immediate help. But after they ask for medicine, most participants also express gratitude. They thank us for spending the time to consider the problems in their lives. I can tell that our study brings them hope. I just hope that we aren’t encouraging a false hope that our study can solve all of their illness and poverty.

*Kaylee experienced this “fact-of-life” first hand last Thursday and throughout this weekend. Her symptoms started with a terrible headache which lead to vomiting, diarrhea, and shivering for several days. Now, like we tell the people of Kejetia, “we’re not doctors,” but it seems very likely that Kaylee had malaria.

** “Ghana, land of the lumps.” I think this slogan summarizes Ghanaian food well. Ghanaians eat lots of starchy grains in big lumps. “Banku” is a big white lump of fermented corn, “fufu” is a big white lump of cassava, “oso” is a dense white lump of white rice, “gaari” is a (more cous cous-like) lump with the texture of fish eggs, and “tee zet” is a (more porridge-like) lump of millet. Ghanaian cuisine usually consists of one of the fore-mentioned lumps and a very oily stew with hunks of meat. They rip off pieces of lump to sop up and consume the stew. Unfortunately, I’m not a big fan of lumps.