Week One

Our arrival at the Accra National Airport was uneventful—a smooth transition through customs assured in part by small "gifts" all around. Only two tiny gates and one baggage claim at this facility; a ridiculously easy airport to navigate, though painful to depart from as check in time for international flights is a long, dull four hours in advance. We were met outside the airport by our guide and a tros tros—an ancient van with no seatbelts that provided plenty of accommodations for our many bags (containing basic supplies such as a water purifier, peanut butter, canned chicken, sheets, and enough medical supplies to enable us to pass for doctors at the airport in Holland.) After we were all packed tightly into our seats (the children were thrilled to see there were no seatbelts to constrain them) we were advised to keep all limbs in the vehicle as close passing buses and trucks have been known to implement an unplanned amputation on more than one occasion. This was not a joke. Traffic is insane. The power is out on schedule every 24 hours for about 12 hours. So we only have electricity 2/3 of the time. Needless to say there is no back up generator for the traffic grid so, during these outages, chaos reigns on every street intersection. During one outage we were stuck in Accra for more than 2 hours and moved less than 3 blocks. There are police barricades set up at regular check points that are intended to protect the city from invasion and assure that all drivers are licensed; however, it is not uncommon to be asked for a "tip" at these check points which will facilitate one's passage without further harassment.

Our new home is in a blissfully rural location. It is a sprawling mud and cement structure—built to accommodate western tastes--that has seen better days. The previous occupants had a cooking fire based in the living room and stripped the home of most of its valuables (including the stove and refrigerator) prior to moving out. The College has made every effort to clean up the house and make it livable, so we had a relatively soft landing for our first night in Africa. We were up with the roosters the next morning at 6 a.m. This was fortunate; as we had several visitors welcome us bright and early our first day. We met first with our host and the director of the College, John Adams. He is a young and energetic man with boundless charm and a perpetually sunny disposition. He runs the College, the high school, a private school in town, the local church, and farms the land around the mission in his spare time. John has visited the States on several occasions and is compassionate to our potential culture shock. Other visitors included our cook, Cecilia, the local minister, a refugee camp coordinator, and several neighbors at the mission. We hit the ground rolling that day—went shopping, established a bank account, enrolled Mason at Mama Jane's International School for primary aged children, and came home to relax with a "beverage" in an authentic thatched summer house that another mission family had courteously constructed (along with a genuine pizza oven) in the back yard. This is where we spend most of our time catching the cool breezes from the ocean to escape the sweltering humidity of rainy season.

We spent the remainder of the week coordinating services for the Budaburum refugee camp. Visited two churches, set up a series of teaching seminars for educators, and began screenings for PTSD. The camp residents are extremely welcoming of assistance and the need for healthcare, educational supplies and mental health services is truly great here. We have been approached by several organizations desiring to take part in our PTSD treatment outcome study

and have made valuable alliances that will be beneficial years down the road. In particular, a partnership with the War Affected Youth organization on the camp has led to an invitation to work with a similar group in Sierra Leon and Liberia.

Week Two

Our week has been filled with hours upon hours of PTSD screenings in dirty, sweltering churches and meeting halls. I've gone through a liter of water every two hours and still can't shake my thirst. The participants are troopers; most arrive expecting nothing but information and free help. All are pleasantly surprised to receive the nominal compensation we offer, along with some water and snack biscuits. One woman came to our screening bearing pictures of her attack by a child soldier in Liberia. She sustained multiple stab wounds on her back, torso, and legs. She was smuggled out of the hospital in a nurse's uniform (to avoid the attacking soldier) and fled to Ghana. Her nightmare was not over once she arrived at the refugee camp. Her attacker followed her to Ghana and has promised to torture and kill her and her family before he returns to Liberia. The authorities are helpless to stop the violence on camp and there is typically a murder a week among the refugees. The stories of torture and abuse are heart rending—one mother was forced to butcher and cook her own son after the rebel army shot and killed him. Acts of cannibalism are commonly reported among the victims of RUF attacks. In church, we viewed an older man (clearly a leader or someone with power) who had been given "a long sleeve and a short sleeve" by the rebel army. This entailed cutting off his left arm above the elbow and his right arm above the wrist. This mutilation prevented grown men from engaging in combat, but also left them unable to work to provide for their families.

I began training the pastoral counselors this week. We meet for two hours every night at a small Lutheran church on camp. My assistants in camp did an excellent job of selecting the core group of 17 counselors. They are bright, intelligent, empathetic, and engaged. I was impressed by their enthusiasm for our training in trauma therapy and by their commitment to their parishioners. In fact, the response to our call for counselors has been so great, that we have been asked to conduct another training session for teachers, social workers and nurses in mid-August. Meanwhile, we made contact with a former child soldier and commander in Charles Taylor's army who is now an activist for the rehabilitation of former child soldiers. M is almost 30 today, but he began carrying an AK47 shortly after starting 8th grade (the year his formal education ended). His leadership skills are evident in his poise, and his scarred face reflects a quite intellect that makes him the perfect spokesperson for this cause. My research team has agreed to collaborate with this young man in the development of a documentary on Liberian child soldiers and a compendium of child soldier narratives to be published as a book. His goal is to "mentally disarm" the young men who are now weaponless, but who learned to live by the gun at an impressionable age. His goal is noble, but there is little financial support or resources available to help him achieve his dream of peace.

We took a small holiday at the beach to recover from the long hours of screening. Spent two days frolicking in the green waters of the Atlantic on a rocky, palm lined beach about 30 minutes from our village, Kasoa. The children loved it and hated to give up the hot shower and air conditioning to return home to cold water and regular power outages. Ate tons of fresh pineapple, drank cold "beverages", and consumed all the beef we could during our stay (we can't get fresh meat in our village). We did come home with a few bed bug bites (that is almost certain in any hotel in Africa) and Maddy erupted in some hideous form of pox the next day, but I suspect she became contaminated at day care rather than at the hotel. Poor thing looks leprous but doesn't seem too miserable given her appearance. Topped the week off with a visit to a town

doctor who scratched his head and gave us an assortment of medicines—antibiotics, lotion, pain killer, and anti nausea medicine. I expect one of them will do the job or it will run its course in any event. (At least she didn't get typhoid like the little boy down the road). And so the adventure continues…

Week Three

Maddy's pox returned after a course of antibiotics.  Began practicing Gonzo medicine as I experimented with the large stash of medicines we brought with us.  Antibiotic ointment for the open sores, a z-pac for anything systemic, and plenty of calamine lotion for good measure.  Seems to have worked as her blisters are drying up at last. 

We graduated our first class of lay trauma counselors and celebrated with a large party at our home.  It was an expensive celebration with purchase of food, household help, and transportation for the 20 some pastors and their partners, but well worth the expense in terms of good feelings all around.  We received many hugs and thanks and experienced a bit of the Liberian sense of a good time as we laughed and told jokes during the ceremony.  I am very proud of this first group of counselors.  It was difficult to choose 8 among them to help with my research.  They are so hungry for education—they devour any articles or information I have to share.  Teaching has never been so gratifying despite the primitive resources (no copy machine, no computers, and no overheads).  Sometimes it is hard to believe we are still in the 21^st century.  Most people still use manual typewriters and treadle sewing machines due to the frequent power outages.  The washing machines here look like something out of a 1930s Sears catalog—with agitator and spinning mechanisms as separate entities.  Very surreal. 

Week Four

Launched the next training session for lay counselors at the camp in conjunction with the Organization for War Affected Youth.  Again, a wonderful group to work with, although mixed in terms of counseling background.  I am challenged by the lack of teaching resources and have resorted to using my own funds to copy materials, but we seem to get by, sharing when necessary.  I have been invited to teach a course in counseling at the Pan African College for Peace Studies starting next week.  I agreed to make a few guest lectures and help them assemble course materials.  With providing individual counseling to 22 former child soldiers, conducting 2 hours of group supervision, and holding therapy adherence checks on eight pastoral counselors, I'm not sure how much time I'll have. 

I went to market with the family this week.  It was a crowded, stifling, and hair-raising experience.  Fortunately, our driver, Joshua, kept a sharp eye out for us and prevented everyone from getting run over by a truck or lost in the maze of booths.  Mason had a sensory integration disorder attack and Madeline fell asleep on Peter's shoulder.  We all left the market a bit overwhelmed by sweat, dust, noise, and the mixed smells of rotting fish and open sewers.  Our two-year old, Madeline, is going native and has begun carrying her toys in a basket on her head and insists on tying her stuffed pooh bear to her back, like the mothers she saw in the market. 

Attended yet another church at the refugee camp on Sunday.  It was a traditional, music- filled celebration of spirit hosted by our Liberian brethren.  Church here in Ghana lasts for hours and most people attend several times per week.  It seems I've spent more time attending the different churches of Ghana than I spent at services over the past ten years. 

The weekend culminated in a visit to a beach resort outside of Accra where there is a charming Italian restaurant called the Italian Beach Garden.  The restaurant is located in a funky garden compound with a few wooden tables, some lawn furniture, and a pack of local dogs and cats wandering between the tables.  Individual pizzas (traditional Italian style) are about $3.  We feasted in the cool ocean breezes with the wonderful company of my research assistant and our driver for less than $35.  It was a nice topper to a long four weeks of cultural adjustment.

Week Five

We have planted a garden in order to produce vegetables that we can eat without concerns of food contamination—squash, eggplant, tomatoes, carrots, and cucumbers have already begun to sprout, so fertile is the soil here.  Otherwise we must treat anything that touches the ground with a mixture of dilute salt or bleach water.  So far, so good.  None of us have gotten sick; although our cook, Cecilia, is meticulous and won't even let us drink the inexpensive bags of treated drinking water that everyone else consumes without a care. 

The mini farm was complete with the addition of a pet rabbit—named Hope if it is a girl, Hopper if a boy.  On my way back from the office the other day, I encountered a baby chick that was separated from its family.  I rescued the week-old hatchling and we are now raising her on Gari and rice.  Lydia is a pretty little chick that grows more each day and follows us everywhere.  Fortunately for her, she can be kept for eggs and her life as a free range chicken once we leave will be a relatively pleasant one.  The attitude towards animals here is pragmatic.  Dogs, cats, poultry and goats are all raised for food, and I note that stray dogs and cats are avoidant of strangers, as though they have learned from experience that hunger is everywhere.  It is rare to see pets and owners demonstrate any affection for each other, although the Liberians seem to have adopted a more American perspective on companion animal ownership.  In general, the Liberians are much more like Americans than the Ghanaians.  They use similar jargon, are more emotive, and have a great appreciation for all things American, especially our food.  In particular, I have found the Liberians in camp very responsive to training in counseling techniques and eagerly embrace a psychological way of thinking.  By request, I am teaching a course at the Pan African College on camp—4 hours a week for 8 weeks.  It is grueling on top of my therapy work, but there is simply so much interest and need that I have a hard time saying "no."  Taught my first class this Saturday and 30 out of 32 students presented in the tiny one room school, despite the beginning of our torrential rainy season.  The rain poured so loudly on the tin roof that I had to shout to be heard and lost my voice after 3 hours.  Later, my research assistant noted that typically when it is raining, teachers stop lessons and have students engage in quiet reading or work until the rain stops.  Live and learn.

Week Six

There is a saying among western visitors that describes the chaos which seems to reign everywhere in West Africa—power that ceases as inopportune moments, petty thefts of dishes and silverware at dinner parties, mud that makes the roads impassible after a rain, herds of cows and goats that clog the city streets and markets, and police that stop you for extensive searches—it is WAWA.  In translation this means "West Africa Wins Again."  It means: The only thing you can count on is that nothing, absolutely nothing, will ever be simple or easy.  The mere act of transporting oneself from one place to another 30 kilometers down the road can take up to six hours in hellish traffic and with two police stops on the way.  Given that our poor driver has been jailed three times for minor traffic offences and had his car impounded once in the past three weeks, we have given up being anywhere on time.  Strangely enough, although this is extremely common, in fact the phrase "I'm on my way" can mean that one will arrive anytime within the next two hours, there seems to be an expectation that we " Abruni " will be more timely in our presentation.  So, I have given up on taxis and have invested in a used 250 cc motor bike to get me around the town of Kasoa and the Buduburam Refugee Camp.  I almost wish we'd invested in this earlier in our stay as the headaches and bad feelings that seem to go with our perpetual tardiness are giving me an ulcer. 

Both our driver and my RA are from royal lineage and both have been presented the opportunity to be a tribal king of their respective villages.  Both have turned down the chance due to ethical concerns.  Evidently there is a tradition of annual human sacrifice to assure the king's health and prosperity.  This occurs at night and anyone not of the royal line can be sacrificed at any time.  The only indication of this event is the remains of a headless body left for the police to find.  The head is burned as part of the sacrifice.  Typically, foreigners and homeless people (but not the mentally ill or disabled) are targeted for the sacrifice, and when it is known that there will be multiple killings (when the king has died or a new king is being initiated) all the village is warned to stay indoors at night.  Although the local law enforcement is aware that this occurs and an investigation is supposedly initiated, no real attempt is ever made to find the culprits.  This practice continues in the traditional manner as many of the villages in Ghana (as much as 70 percent of the people) still practice tribal religions as well as Christianity or Islam.  When the road was being constructed in front of our mission, a tribal burial ground was unearthed and a half dozen sacrifices occurred in order to assure the peace of the dead kings.  This casts a new light on a story I heard of the earlier occupants of our home who reportedly went crazy and boarded up the doors and windows of the house and refused to go out for more than a year.  It took flying a relative into Ghana to convince them that is was time to leave.  What with the strange and vivid dreams triggered by our malarial medicine and the powerful culture shock, I could see how someone might become paranoid if several headless bodies showed up in the near vicinity of one's home.  I can only hope that someone will tell us if one of the two current kings of Kasoa pass away.  As oblivious foreigners we would be an easy target and no one is safe—not even children or police.  Last year a 13 year old Liberian boy was brutally killed as part of a ritual sacrifice—pictures were taken and shown throughout the refugee camp.  The stories of death and survival continue to shock me on a daily basis. 

Week Seven

Lethargy accompanies the constant downpour of rain and continuously gloomy skies.  It seems we have exchanged the constant dust and sweat only for mud.  It is impossible to ever feel clean here, and now that the humidity is high, nothing we wash will dry so that there is the constant scent of mildew in our clothes.  I have completely given up on personal hygiene and have begun taking my brief, cold showers at night so that I can relish the few hours in bed as my only few hours of feeling clean and refreshed.  The second I get up the grime begins to accumulate.  My feet are black by the end of the day and we all must remove our shoes when we go in and out of the house.  I have no idea how West Africans can appear so spotless in both their person and clothing.  It is uncanny, as after a trip to the market, my whole family looks a bit like Pig Pen from the comic strip Peanuts.  Women at the refugee camp go out in full make up with beautifully styled hair and painted toenails.  I feel quite frumpy by comparison. 

Met another psychologist on camp this week.  She is a German doctoral student who is providing peace-building education to select groups in the hopes of developing interpersonal arbitration skills.  This courageous soul is living in rental housing on camp and has no friends or family in the near vicinity.  She discovered her contacts in the refugee camp over the Internet.  I was impressed by her initiative and independence.  The program has similar goals to our own, but does not attempt to provide trauma healing therapy to the refugees.  It is nevertheless comforting to meet someone with similar interests and goals as myself.

We hope to get a land line installed at the house this week.  We have been using the phone at the local college to access the Internet but are required to pay for time in advance at a rate of $11 per hour.  After loading some $33 on the phone and having more than 24 hours of phone time disappear into limbo (I suspect one of the employees is using the phone line for personal long distance), we have decided it would be more economical to have our own phone installed at the house.  Lord knows how long this will take; WAWA would suggest that it may be installed at least by the time we leave.  I have come to hope for the best, but expect the worst in all things.  I suspect the gloomy weather has contaminated my mood to no small extent.

Week eight

As I write this there is a haunting chanting and rhythmic drumming in the background.  It sounds a bit like the tribal drumming in the background of old Tarzan movies.  It is surreal to have a personal sound track accompanying my every activity and the music can go on for hours. 

Peter has completed his interviews with former child soldiers and his educational seminars.  He ran into one of the ex-combatants on camp yesterday and the fellow begged him for money as there was "no food in the house for his children."  We are regularly asked for money from people who perceive us as rich.  After making personal contributions of more than $1,000 to various individuals, charities, and institutions, we have run out of money.  I have therefore put Peter on a budget of $25 a month to give away as he sees fit.  When it is gone, it is gone.  It was gone within the first 4 days of the month.  So with great sadness, he had to turn down this veteran's request.  Later that day Peter met the same fellow who was buying a pack of cigarettes and a beer at the local spot.  We have since become a bit more savvy about the con of Abruni who are thought to have money to spare (and relatively, I suppose, most of us do).  This does not negate the true need that exists on camp.  On Friday, I finished my first week of counseling with the former child soldiers.  One of the gentlemen I worked with received the cedis we paid with a large grin.  When I suggested he might treat himself to something nice he agreed saying he would buy an individual bag of treated water for each of his children.  It was very sad to me that the purchase of water would be considered a treat.  The great difficulty is separating the true need from the cons.  There is some respect here, culturally, for the trickster Anansi.   To get money or goods through trick is admired, while outright stealing carries severe penalties.  I continue to learn more everyday.

Week nine

Second week of counseling is complete.  The stories continue to be harrowing.  I often wonder about my own ability to cope with the repeated exposure to trauma that PTSD counseling requires.  I have some 24 individual clients and 8 more group clients among the child soldiers.  My pastoral counselors have already started seeing a core group of fifty war victims for three weeks now with great success.  It is heartening to hear the stories of healing and gratitude from the counselors.  It would seem that many of our participants have experienced some relief from their trauma symptoms already, responding perhaps to the treatment paradigm I have developed or perhaps to the power of interpersonal process groups.  I worry for the mental health of my counselors, as well, however.

At home we have begun a small farm venture.  The baby chicken we rescued has been joined by an adult hen who has taken it under its wing, so to speak.  They are ridiculously tame and will sit in your lap indefinitely.  The rabbit is becoming fatter, though not much friendlier (this does not bode well for its longevity once we leave).  We are settling in and making small improvements around the house—painting, refinishing furniture, installing a bathroom cabinet, and building a small pond for wading and/or fish.  Peter has taken to planting shrubs and bushes to the already tropical landscape, and as my son put it recently, "This house is starting to feel homey now."  I would have to agree that we have settled into a routine of sorts at least.  For the next four months, this is home.

Week ten

We escaped to the north country (Volta and Aburi) this week for a long weekend.  Stayed in a modest hotel in Dodowa where they had an extensive menu of Italian and Chinese offerings that were not available.  After several queries as to what exactly was available we were told that there was only chicken and jollof rice.  So, chicken and jollof rice it was.  The north country near the Volta reservoir is stunning country—lush and green, rolling hills— unlike the central region which is unnaturally flat, dry and rocky.  The little villages at the top of the hills are ancient and picturesque—a mix of traditional palava huts and colonial architecture.  We stopped at the Volta dam (the main source of electricity in West Africa) and an old bead producing town where used glass is ground up and rebaked into lovely, colored glass beads.  On day one, we visited a game preserve where we fed bananas to wild baboons and hiked up to a bat cave that in earlier times served as the base for a tribal leader during times of war.  The next day we visited the Aburi gardens where the British colonials established 30 acres of tropical gardens—a modern Eden where the scents of eucalyptus, cinnamon, clove, bay, and other aromatic trees overwhelm the senses.  We took a meandering path through a palm grove and startled a gathering of hundreds of multihued butterflies.  The colors were extravagant and the gardens themselves provided a shady retreat from the unrelenting heat of Ghana.  Only one downer on this junket.  During the trip we stopped at a restaurant for a beverage and snack.  We ordered a bottle of water and it arrived ice cold and dripping with moisture.  Our guide opened the bottle and I quickly poured it into our glasses after which we all drank the iced water thirstily.  It wasn't until we had finished the first glass that our driver looked alarmed and said "this is tap water!"  Sure enough, the restaurant had refilled a bottle of mineral water with tap water and served it to us as though it was purified.  All of us but the baby (who drank less) got our first case of dysentery.  Despite our precautions, it seems inevitable.  Our health, otherwise, is remarkably good.

Week 11

Our son Mason has return to classes and has been tormented by the other fourth grade students who hate his blond hair and green eyes.  He returned home in tears and we placed a request for him to be moved into the fifth grade where the children are a bit more mature and seem relatively fond of him.  This is our first experience with true racial prejudice, although it is not uncommon during a trip to town to be hounded by cat calls of "Abruni" by the Ghanaians or by "White" by the Liberians.  This seems more a statement of surprise rather than one of derision.  In fact, I have been rather pleased with my first experience as a minority.  It is very strange to be the only white person around for miles, and I always feel a jolt of surprise when I see another foreigner on camp.  There is a sense of familiarity and comfort being around others that look like you, but in general we have been welcomed with great tolerance by the majority of our hosts.  It is really the cultural differences that are more shocking that the racial differences.  It does seem that in terms of emotional temperament and customs, we have more in common with the Liberians as they tend to be more emotionally demonstrative and open.  The Ghanaians are more reserved and less emotional, but this has perhaps served them well as they have also had 50 years of peace whereas the Liberians have suffered from 17 years of non-stop civil war.  Even as recently as July there was a coup attempt in Liberia against the new president.  I heard a story of a man who recently returned to Liberia and the second he crossed the border he was attacked by rebels (who still live in the bush) and had his leg cut off.  Although Monrovia remains relatively stable, the outlying country continues to be highly volatile.  This gives me pause when I contemplate an invitation I have received to serve as a guest lecturer at the University of Liberia next July.  As the Liberians in the camp, I, too, feel inclined to wait patiently to see how effectively the government copes with the rebels if and when the U.N. forces withdraw from the country. 

We visited WACRO this Saturday and I spent an afternoon reading out loud to the children and teaching them games of Simon Says and Duck, Duck, Goose while Peter taught them computer graphics.  The kids are a blast to spend time with but it is tragic that universal education is not yet available and so many are unable to attend school.  I have been approached more times than I can say with the request to sponsor someone's education.  The one time I did pay the $80 for a semester of school, however, I regretted it immediately as the student did not show up for his high school classes nor did he show up for his work scholarship duties.  When I told other Liberians of this sad situation they were outraged that those funds should go to waste when another student could have readily used them for legitimate purposes.  I suppose I must find another way to provide assistance since I obviously can't afford to send every student to school who desires financial aid.  I have even been approached by college students who wish me to pay anywhere from $10,000 to $30,000 to fund their higher education.  There certainly seems to be a common misconception that all Americans are rich.

Week 12

This week is marked by mental crash and compassion fatigue.  No matter what I do here it never seems to be enough.  Every day I am asked to pay for school, rent, food, doctor bills, and medicine.  I do what little I can, but soon we will be in dire financial straits and even then what we have done will be only a drop in the bucket.  Many people have genuine needs—one woman has breast cancer and cannot afford her medicine, another woman has colon cancer and cannot afford chemotherapy, a man I know has been crippled by a bullet that remains in his spine and needs neurosurgery.  Many people are simply looking to get what they can from us while we are here.  It is exhausting separating the two groups and even then, it is exhausting attempting to find help for those who genuinely need it. 

I am also finding two groups amongst those I work with.  Some genuinely want psychological help with their symptoms.  Others are simply looking for a sponsor and think that therapy is a good way to develop a relationship with an American who can sponsor them.  Those who sincerely desire psychological help seem to be improving tremendously.  Those who are looking for a hand out have experienced only frustration and disappointment.  It is very discouraging. 

My son found a tiny calico kitten that had been abandoned in a tree by its mother last Sunday and we nursed it back to health with baby formula.  Though very young, it looked as though "Olivia" would survive until the cook insisted we give her a bath because she was covered in fleas and ticks.  Despite the bath we could not remove all the ticks and I thought to treat the kitten with mosquito repellent.  Unfortunately, the DEET in bug spray is a neurotoxin and it does not take much exposure in a kitten to cause brain damage.  In my haste to treat it for parasites, I fear I caused permanent brain damage.  I slept with it all the night to keep it alive but in the morning it started to cry piteously and died shortly thereafter. 

This incident came the night before I read an essay written by one of my students who saw soldiers bury 150 children alive with a bulldozer.  Even my composed clinical front cracked after I read this essay and I spent the next 12 hours crying myself dry for the brutality of war—particularly the Liberian civil war.  I was a mess for my first client who kept begging me, "Please stop crying sister Lucinda." I successfully pulled myself together for the rest of the day.  The stories are horrific and I know that I am only hearing a fraction of what truly occurred because even my clients and students edit their tales for my American sensibilities.  I suspect I will never be quite the same after this experience as the adage, "Ignorance is bliss," is entirely true.  I am learning so much about the psychology of war from this refugee population, but I am not certain that I will be happy in the same carefree way that I was before meeting the people who have been touched by this senseless violence.  For those of us who have never seen a war fought on American soil, it is almost impossible to imagine the mental, physical, and tangible devastation that war produces.  Survival under these circumstances is truly a miracle and I am in awe of those who endured and have rebuilt their lives under the most untenable circumstances.

Week 13

Perhaps the number 13 is indeed ominous.  This week found me nursing our ten year old son, Mason, through a terrible bought of malaria.  He woke me early Friday morning with a raging fever and chills and I promptly gave him a handful of children's aspirin and cooled him down to a safe temperature with water and a fan.  I stayed up the rest of the night with him until his fever dropped and he was only complaining of body aches and a throbbing head.  We have taken our malarial prophylactics with regularity, so it surprised me that it broke through, although I understand there are resistant forms of malaria, especially in Africa.  The following week we took him to the clinic in town where he and Peter waited four hours in a packed waiting room to be seen by a barely competent physician.  Once infected, he will likely have recurrent cases of malaria for the remainder of his life.  It is a debilitating illness that lasts for a week at a time.  I know of several people who die of it due to the high fever and brain damage it can cause.  It seems he was likely infected as we visited a small fishing village where a former Danish castle from the 1600s still stands on a remote bluff overlooking the ocean.  The castle and the village were hardly worth infection, although we did get to pet a baby goat which is a novelty as they are hardly pets here in Ghana.  Winding up our research project, both the group study and our individual therapy is keeping me busy, and hence away from the keyboard for much of the week

Week 14

Just when you think it can't get much worse, it does.  The only thing that beats having a child with malaria is getting it yourself.  I don't think I quite appreciated what a trooper Mason was until I came down with a severe case of malaria myself this week.  It started with an ache in my lower back and neck and spread to a swollen lymph node in my side that became so enlarged it impeded my ability to breathe properly.  Gasping and sweating, I completed my third day of therapy and prepared for what I expected to come that night.  I dosed heavily on Tylenol 3 and crashed early expecting discomfort but not the raging fever of 103 (on lots of fever reducer) or the aches, chills, and fatigue.  To top it off, I couldn't sleep due to the intense discomfort that shot up my right side from the swollen lymph node.  The next morning I drug myself to camp once again to face a grueling client load of six patients in 100 degree heat—all with severe trauma.  I fell asleep in my plastic chair waiting for my first client yet managed to show some enthusiasm for the remaining five with the moderate explanation that everyone seems to understand that I was a bit under the weather with malaria.  That is often enough to knock even a hearty African off his feet for a week at a time.  I took time out only for a pregnant woman to start labor in my office—one of the students at our school in her last month of pregnancy.  I was selected for this honor because I seem to have the label doctor affixed to the front of my name.  It was with great difficulty, and through a fuzzy, feverish haze, that I tried to explain that I am not THAT kind of a doctor.  I was only able to hold her hand and swab her forehead with cold water while a more competent woman (a hairdresser brandishing a latex rubber glove) checked her dilation and whether her water had broken yet.  Between screams, I assured her that everything would be okay and prayed that the taxi would arrive before my next real patient showed up.  When in the confusion it became clear that no one had money for taxi fare, I happily opened my wallet and offered a five cedis note to pay for the car and get her checked into the hospital.  If nothing else, my doctorate was good for something--in this case, supplying a bit of cash and consolation.  Otherwise, when the baby arrived, my training would have equipped me only with the sense and skills to enquire, "So how does that make you feel, little one?"  And I think anyone could guess the answer to that question.

Week 15

This week dawns with yet another case of malaria as our baby girl came down with a horrific fever at the end of the day—she was burning up and so groggy from delirium that she fell asleep at the dinner table.  One touch of her skin and I leaped into action—pouring Tylenol down her throat and dousing her with cool water from the fridge (our power was out again so the water was only tepid).  My experience with this disease tells me that if you can make it through the first night without succumbing to the fever, all is clear and it won't return at quite the same level of severity the next night.  And so tonight we all wait and watch with baited breath, prepared to call our driver to take her into the hospital in Accra if that should prove necessary.  However, my phone minutes are low and the land line has been acting up, so we may be on our own tonight in any case. 

The next night she spent throwing up continuously.  I went through three sets of sheets (all of which must be hand washed) and spent a sleepless night comforting her.  We went to the doctor the next day to get malarial medicines and to have her re-hydrated.  She survived and recovered quickly, as children tend to do.  My husband also came down with the disease a few days later so that makes all four of us to date.  The biggest drag is that malaria lives dormant in your liver and recurs when your immune system is low.  So we will now all have malaria for life.

Week 16

The end of four months in Africa is marked by our celebration of Halloween:  The children dressed in their African garb and came to our door four times shouting, "Trick or Treat!"  Peter answered the door each time and exclaimed, "Oooooo, scary!" as he gave them some of our melted chocolates.   We then carved a watermelon to look like a jack o'latern and made hot cider (despite the 100 degree heat) and popcorn and watched a scary movie called "Bug."  It was anti-climatic for the kids, but wait till they decorate a palm tree for x-mas and we will have fodder for parental guilt for years to come! 

The weather has become increasingly unbearable—100 degree baking heat with a little respite courtesy of the ocean breezes and occasional torrential rain.  Even the Africans look miserable.  Only one week left in my treatment study—so I will be avoiding camp for the remaining two months with the goal of recouping my emotional energy before returning to teaching.  I will retain only a few individual therapy clients who appear to continue to need ongoing psychological help.  We will spend our remaining time scouting adventures for our return in July 2008 with a BSU student group.  Possible visits to the Gold Coast, Mole national game preserve, and a witch village up north have some allure, as does a return visit to the lush Volta region.  More on this as the adventures pan out.