This summer I am blogging from Kumasi, Ghana. The first year of medical school ended in a blur of moving apartments, taking my last M1 final, hopping out to my high school friend’s bachelorette party/reunion in California, back home to Long Island for a few days of packing and an Indian fusion wedding, and finally out to Kumasi, where I have lived for one week as of today.
Kumasi reminds me of my days in Kovalam and Chennai: the smells, the red earth of the road during the rainy season, the brightly colored hodge-podge of buildings, the lush vegetation of coconut trees and red flowered bushes, the tailoring shops and street food vendors and piles of shoes, pots, and mobiles in plastic stands spilling out onto the streets for sale. In other ways, Kumasi is also different. The Ghanaian cuisine we’ve sampled at the various student canteens here at the Komfo Anokye Teaching Hospital and surrounding medical student hostels where we live do not offer the year-long vegetarian’s haven I enjoyed in Chennai. Of the few vegetarian foods I’ve tasted this past week– a mixture of meals that include a mildly-spicy fried rice called “joloff”, a beans and fried plantains dish named “red-red,” spicy gingered fried plantains with ground nuts bought piping-hot from street vendors as “killie-willie”—my favorite street food is indeed the “killie-willie,” but favorite meal is “kenkey”—a starchy, fermented corn that is served warm within its husk with two types of spicy tomato sauce.
Unlike Chennai or Ann Arbor or New York City, I don’t blend in here. People constantly ask me if I am from India (usually phrased as “Do you have Indian blood?” or not even as a question—simply, “You resemble an Indian”) and are a little confused when I tell them I was born and brought up in the States. Yesterday, Vivian and I were in a Lebanese-owned Target-like store called Melcom, where one Asian man spotted her and tapped his two Asian friends and all three looked at her and waved. She waved back. Her Cantonese ethnicity continues to baffle people when we introduce ourselves as from the US and from the University of Michigan in the hospital wards.
And as in Chennai, I’ve begun similar explorations of the mental health landscape here in Kumasi. Through the Michigan Global REACH program, I am part of a research team of four medical students and we are investigating physicians’ views of coping with stillbirth and infant death and mothers’ experiences with stillbirth, infant death, and post-partum depression. While the topic sounds so heavy when seeing it here written on the page, the first day of interviews last week was inspiring. Listening to one obstetrician’s stories of coping, of loss, and of his ideas of what could be improved, I felt that this was the only path I could take.
Last Friday I had the opportunity to shadow on the Labor and Delivery ward—the head midwife, a feisty, warm woman who daily wears an IPAS pin that states “Women’s lives matter,” told me that it was a slow day and so she was renovating the ward by hanging up pink and blue curtains—and still, on a slow day, I managed to see a caesarean section and my first vaginal birth within a few hours. (Today, she told me that I should have come because the midwives had delivered several babies, including two sets of twins, by noon!) During the cesarean section, my mentor, Vivian, and I stood in the corner, decked from head to toe in scrubs and masks and surgical hats, and our mentor explained to us how the obstetrician was systematically cutting through skin, fat, fascia, and then into the cream-colored uterus. The baby’s head appeared so quickly and it emerged, covered with the white residue of amniotic fluid, dangling from the obstetrician’s grasp. A house officer cut the green umbilical cord and a midwife whisked the writhing baby away into an incubator in the corner of the theater. As the physicians sutured the incision across the woman’s belly, my mentor told us that their techniques were incredibly efficient, and had to be, given that they practice in a low-resource setting.