#and ill probably have to lead the discussion Thursday on the analysis of our results with the undergrads bc i prob kno the report the best

[jasonhaw]

Life in Ghana 7 (9/13 - 22): The Unwavering Kindness of Ghanaians

It has been seven weeks since I have arrived here and I have probably talked to dozens of Ghanaians by this point. Every single one of them has been extremely kind and generous and hospitable. I borrow some words in Filipino: Wala akong masabi (I have nothing [ill] to say). This week I share about 5 little acts of kindness over the past week.

1. Tuesday (Sep 12): We visited the District Health Office of the neighboring Ningo-Prampram district (Dodowa is in Shai-Osudoku, and both Ningo-Prampram and Shai-Osudoku used to be part of the same district, Dangme West). We were welcomed by Dr. Gifty Ofori-Ansah, who welcomed us with kind words and a comprehensive presentation on the health status of the district. From the moment I talked to her, I can tell that she is a very smart, decisive, and open-minded woman, and she was kind enough to offer her input to the research topics of Natalie and Allie, who are still in the process of writing their proposal. We also met some of the supervisors managing the different health programs like family planning and infectious disease control. 

What I admired about her was her humility and dedication as a public servant when she was talking about the issues that plagued her district - teenage pregnancy, quack doctors (and its relationship with religious faith), and the rising burden of non-communicable diseases. She reminded me of the hardworking municipal health officers that I have met so far in the Philippines. It is people like her that continue to give me hope about public health - that most of us have good, wonderful hearts always ready to help those in need.

2. Monday (Sep 18): I presented my initial results to the staff of the research center and the room was packed. Days leading up to the presentation, I felt a bit uncomfortable because I did not want to feel like a foreigner telling them what their health system is like given that these are researchers who have spent their careers understanding their own health system. After I presented, my colleagues gave wonderful and helpful remarks on how to improve my paper. One thing I appreciate about Ghanaians is that they always have a sense of humor even in the driest of things, such as presenting something as technical as statistical analysis. After that presentation, I am more confident in finishing my presentation.  

3. Tuesday (Sep 19): I had two tasks that day: go to immigration and extend my visa stay, and visit a professor over at the University of Ghana who has written extensively on the topic of quality of care perceptions, which you may recall is also my topic for my scholarly paper. The Ghana Immigration Service is the first government office I have transacted since arriving here, and while the office is a bit chaotic, it is miles and miles better from the Bureau of Immigration back home. First of all, there are no fixers! Fixers, as officially defined by law in the Philippines, are "any individual whether or not officially involved in the operation of a government office or agency who has access to people working therein, and whether or not in collusion with them, facilitates speedy completion of transactions for pecuniary gain or any other advantage or consideration." We have a law that explicitly bans fixers in government offices (Republic Act 9485) but of course, just like most laws in the Philippines, no one implements them. Second, the immigration officers have been extremely helpful, unlike the ones in the Philippines where a lot of them are snarky and powertrip foreigners.

After that trip to immigration, I visited a professor at the University of Ghana Business School and an expert on quality of care perceptions in hospitals. We had a very fun and fruitful discussion on his papers, and I also consulted with him on my method. He was very honored that someone read his 400 page dissertation on the topic, and I told him that I love doing research so 400 pages is a breezy read to me. At the end of the meeting, he agreed to review my paper and comment on it. I am so honored to have someone so knowledgeable on the topic review my work.  

4. Wednesday (Sep 20): I left early again to visit another professor who is currently based in the University of Health and Allied Sciences at Ho, the capital of Volta Region, which is east of Greater Accra Region. The ride took almost three hours getting there - mostly because Ghanaian roads are not paved (which makes me carsick most of the time). The trip was definitely, definitely worth it. I cannot stress how engaging and fruitful our discussion was. He has written a lot of papers on the topic of health care quality, as he also did his dissertation on it. What particularly interested me was how he ended up doing his PhD program, which I hope I will have the opportunity to have in the future when I finally study for my PhD. In short, he was my #PhDGoals. In summary (and if I understood it correctly): The National Health Insurance Agency (= PhilHealth in the Philippines) asked help from the Dutch government to solve their issue of low population coverage/ enrollment into the scheme. The Dutch government gave them a grant, and allowed three PhD students (one from Ghana Health Service, one from the Netherlands, and one from the school where Prof Kaba was affiliated at that time), and one postdoc (who is now head of research at the insurance agency) to be principal investigators in distinct but interrated parts of the project grant. Prof Kaba was primarily responsible for doing the quantitative work in assessing the impact of the project, which was a community trial that used community engagement as a tool to improve insurance enrollment. Since then, he has written 9 published papers on the topic (in very reputable journals like PLoS One)! 

What particularly impressed me with his PhD journey was that: (1) he was involved with the insurance agency the entire time - and some of his recommendations have been turned to policy, such as the issuance of the cards on the same day, and the shift to biometric insurance cards, and (2) the PhD students leading the studies had a lot of freedom with their paper, with national implications. I have never seen anything as seamless and empowering as his PhD program, and all I could think about during that meeting was how we should emulate this in the Philippines. Like this was my lightbulb moment for my PhD program - I want my PhD program to be structured like this. I will not settle for anything less. 

But going back this professor, he was so, so kind. First of all, he saw my undergraduate thesis online (which is published in a Scopus-indexed journal) and was very interested with the findings we had on family planning in urban poor communities in the Philippines. I was so flattered someone actually read our paper. Second, he wanted me to invite for lunch but I had to decline as I had matters to attend back at the research center before office closes (remember the journey back is 3 hours!). Finally, he was just a guy who had a lot of good vibes, showed love for his country, and is very intelligent. I am so grateful to have met someone as inspiring as him.

5. Thursday (Sep 22): I will post more about this in my next post next week, but we went to a nature reserve in nearby Shai Hills. But going back to the overall theme of kindness of Ghanaians, I just want to remark how everyone has been so kind to us whenever we ride the tro-tro. As lost foreigners (oburonis), we would not have known where to go, but someone - either the mate (conductor) or a kind passenger - always tells us where to alight and what to ride. Even the taxi driver that took us home from the reserve did not scam us (or at least based from our computations as we spent around 30 cedis in tro-tros coming there, and the taxi home was just 50 cedis).   

Honestly, this country is just oozing with kindness, and I am starting to regret that I only have four weeks remaining here. I honestly want to extend but matters at home are more pressing at the end of the year. Ghana's tourism slogan should be, "Visit Ghana for good vibes."