Hello and Goodbye (for now)!

Hello, folks!


^Some of the staff at Passion Clinic, my partner in the program, and me outside of Passion Clinic. We look simultaneously extremely dorky and cool and I love it.

Sorry for the silence over here for the past couple of months (oops). I arrived home safe and sound and have since spent much time wishing I was back in Ghana and adjusting to another crazy busy undergrad year. But now, I figure it’s time to wrap up my experiences abroad and address a few of those worries from the start of my journey.

Clinical Notes

I thought it’d be interesting to share a few of my internship notes as a final reflection of all that I saw, both the mundane and the terribly exciting. These are my raw observations and interpretations, and looking back, I’m so glad I (somewhat) obsessively took notes. And so, a day in the life at Passion Clinic!


^This was taken towards the end of July. I spent the day in a hospital and saw three C-sections! And I held a baby! I teared up when I heard the first cries. Life, guys. It’s pretty rad.


-family brought in elderly woman in a wheelchair. She was here a little bit ago from a stroke that left her with left hemiplegia. Today she complained of severe chest pain and a cough. The doctor thinks she wasn’t taking aspirin, causing an embolism to form and cause the cough and pain. He referred her to a large hospital with x rays and necessary equipment to remove the embolism.

-a 3 year old and his mom came in. The kid had cuts in his forehead from a fan. They cleaned the wound and put iodine in it. He wasn’t too happy with that, but his resistance was the sweetest. He would softly cry and try to bat Christine’s [a nurse] hand away. At one point, he sat in the ground and just looked sad. He also tried to grab his mom’s hand and pull her out of the room. Once in the waiting room, still softly crying, he tried putting his mom’s purse on her to get her to leave. As soon as they left the building, he stopped crying.

-mom comes in with her 6 wk old baby. Everyone just sits around, eating peanuts, instead of starting the check up. Baby has an umbilical hernia that they’ll fix (someday) with surgery to push the hernia back in and suture it closed. When the baby got fussy, the mom would immediately start breastfeeding. The openness by her and the acceptance/ tolerance of everyone else was beautiful.

-the power went out around midday. Lack of electricity makes having everything handwritten make more sense. No use depending on something that leaves often enough.


-a 2 year old girl is in with malaria. She’s been vomiting and having diarrhea countless times the past couple of days. Poor thing looks exhausted and could barely protest when given the IV (DNS). Her parents are both very attentive and clearly worried. The doctor explained that they can only give her half the IV bc of her size (that’s a thing for pediatrics)

-man in early 20s came in to get a head wound dressed. Yesterday he came in with a huge gash on his head from getting accidentally whacked by a machete. He got 7 stitches. The bandage wraps all around his head.


-Saw a woman get an ultrasound. She’s 4 weeks pregnant! I have no idea how the doctor identified the fetus in the ultrasound–it didn’t look like anything was there! I could only see pulsing that the doctor said was a blood vessel but not the fetus.

-the same preacher came in for morning devotion. He was here for about 20 min. The first 10 were for singing and individual prayer, the last for preaching. I have the bad habit of tuning out preaching, but I think the gist was the god makes impossible things possible. I liked the heavy emphasis on personal prayer. I heard lots of expression of gratitude. It almost sounded like meditating.

-doctor explained a few things about the anesthesia during a cs. The drug is heavier than CSF, so the patient needs to be upright to let it settle lower than the phrenic nerve. Also, it is a vasculodialator, and that’s why the blood pressure lowers when it’s injected. To counteract the bp from lowering too much, the mother is given about 1L of saline IV before to keep the volume higher.

-pregnant mom came in with a note about her baby from Pentecost. The baby has a right cryptorchism, so our doctor found a doctor that can handle the confusion and lower the testicle. Otherwise, it’ll become cancerous by the time the male is about 30 years old.

-talked more about fertility with the doctor. There’s a huge stigma here if you don’t have kids. If a lady has uterine fibroids, she has a myomectomy immediately to increase her ability to have kids. Also, IVF and egg/sperm freezing are becoming more popular. IVF is about 20,000 gh, egg freezing about 1,500, and sperm freezing about 500.

-woman came in with a man. Not sure if he’s a relative or bf. But she has a swollen, black eye from domestic violence. She was wearing an oversized black hoodie, and would slump her shoulders and wear her hood, keeping her head down. She received a tetanus shot and was given antibiotics and NSAIDs to reduce inflammation and prevent infection. I’ve never knowingly seen a domestic abuse victim in person. It’s very tough.

-man who came in with the machete wound the other day got the wound re-dressed. He also had x rays with him, showing that his skull wasn’t damaged. There is edema by the stitches that the doctor says is part of the healing process.

-a pregnant woman got a shot of iron

-doctor explained 3 types of venom from snake bites: hemotoxic, neurotoxic, and musculotoxic.

-2 young sisters came in to get anti malaria shots. Their cries fed off of each other and it was just a teensy bit funny.


-Joe [an administrator] brought us each apple juice and a big box of biscuits!

-woman (with family holding) stumbled in, no control over body movements. As soon as in a bed, in cardiac arrest. Heart beats very far apart (bradycardia) and unintelligible bp (bc blood not pumping strong enough to extremities). After starting a RNS IV (that took a while bc low blood flow) they gave her an adrenaline equivalent to increase her heart rate and thus bp. Then her bp skyrocketed to around 180/130, so they gave her another injection to bring it down. They also gave her furosemide (I think) to get her to pass urine to make sure she didn’t undergo renal failure. They placed in a catheter to monitor urine. They also gave her an oxygen mask and positioned her body on the side so if she throws up, she doesn’t choke on her vomit. Within about 20 min, she regained consciousness. With time, she could slowly, laboriously move her limbs and barely whisper.

-the doctor got us rice and chicken for lunch!

-saw Florence remove a 5 year old birth control implant. Because it’s been in there for so long, the tissue (fat) surrounding it grew around it, making the implants difficult to remove. After removal, the patient received a depo shot.

-I was standing outside the clinic, waiting for the doctor to have a spare moment where I could thank him for welcoming and teaching us. A girl about my age walked up to me. She got close and said “I’m four and a half months pregnant. Can I get rid of it here?” I stopped short a bit. It was my first time meeting a woman who openly wanted an abortion. I told her to meet with a doctor or nurse, as they’re qualified to talk about that, but she didn’t want to do that. She asked to see the pharmacist, hoping for a drug, I think, that could induce abortion. I asked her a few questions, and she said she’s 20, took a pregnancy test to know she’s pregnant, has known for 4 months, and the baby daddy knows too. She looked a bit skittish and scared, but the smiley type of scared. I didn’t know what else I could do for her, but she looked like she needed help. Probably another one of my most poignant experiences here. Naima [another nurse] just told me that the girl also went up to her and asked for a friend.

-man came in needing dressing for feet and knee wound. He only had 30 cedi on him and was worrying about the total cost of everything.


Honestly, I’m still trying to process all I observed. Passion Clinic is small and its medical care capacity is extremely limited, yet a large number of people were treated for malaria and received wound treatment, antenatal care appointments, and birth control. For such a small clinic, it provided the basics for a significant number of people. I suppose that’s what really matters in the end.

But of course, there were the extremely poignant patients. I’ve never really considered domestic violence and abortion from a medical perspective before. I still don’t know what to make of what I saw or what I should have done. What role should I, an international and pre-med student, have in situations like that? And looking to the future, what role should I, as a doctor, have in those situations? I suspect these are things I will grapple with for a while yet.

I remember several times, Dr. William turned to me and, almost as an apology, said, “This is the African way of doing things. It’s the best we can do.” Yes, the healthcare system has flaws. More than once, I raised my eyebrows at what I saw. Yet ultimately, I recognize that the patients received sufficient care from incredibly hardworking and caring personnel. I hope to have such fortitude and spirit as a healthcare practitioner someday.

And now, to address those concerns/ worries I had before I embarked on my journey!

Flying Internationally Alone

Friends, I can fly internationally alone! How rad! How empowering!

Of course, flying always comes with risks, but having all my ducks in a row, knowing where I was going, and getting to the gates ridiculously early helped calm some of my nerves.

Transportation in Accra

Gosh, trotros. What a wild ride. You will be pleased to hear I did not get lost and a trotro broke down on me only once! I had a trick of sitting as close to the mate (the person on the trotro who collected fare and told the driver when to stop) as possible and being very insistent when my stop approached. I found, more often than not, that mates and fellow passengers were kind and understanding of my unfamiliarity with the system.

Another handy little tidbit for transportation in Accra: Ghana has Uber! How delightful! If, say, I wanted to go out in the evening, it was far easier to call an Uber than figure out nighttime trotros.


^A trotro making its way through Madina market.  

Working in a Medical Capacity

I think my worry for working in a medical capacity (and possibly doing more harm than good) isn’t one that evaporates within a couple of months in a foreign country. Instead, I have a hunch I’ll carry around this worry for the rest of my life. But I earnestly believe if I have the best of intentions and am prepared and knowledgeable, I will do more good than harm.


I have mixed feelings on bugs. Initially, I only worried about mosquito bites. This was a very worthy worry, as it turns out, because I am particularly attractive to mosquitoes and have somewhat intense reactions to their bites. As in, the bite would swell to the diameter of an orange, turn red and hot, and leave a bruise in its wake. Very strange.

But other bugs were silently waiting to eat me or burrow into my skin that I didn’t even know to worry about! (Look up “neglected tropical diseases” if you really want to get freaked out.) I have a lingering fear of getting schistosomiasis (think of baby worms that hang out in freshwater and can bury into your skin and leave you with an extremely morbid disease) and will never take swimming in freshwater for granted again.


^Do you see that mosquito bite??

Ghanaian Food

I don’t know why I worried about this at all. Just read my previous blog post to get a glimpse into bright and lively (can food be bright and lively?) Ghanaian food. I miss it immensely.


^Fruits I wish were in my belly right now.  


And would you look at that, I crossed off every item on my bucket list/ fear list! Giving myself a pat on the back right now.

Lastly, I’d like to thank you, dear reader, for sticking around and listening to my ramblings and musings. I had the time of my life in Ghana, and sharing this journey with you made it all the better. Even now, I find it difficult to articulate all that I’ve observed, all that I’ve learned, so a real kudos to you for bearing with me.


Lots of love,



A Glimpse into Ghanaian Food!!!

This is the post you’ve all been waiting for. Food.

I hesitate posting this now, as no blog post will ever do Ghanaian food justice. But alas, my time in Ghana is coming to a close, and I figure I must post it now or never.

Ghanaian food is not something to be trifled with. It’s not cute, it’s not photogenic. It’s heavy and it’s spicy and it’s amazing. Also, please keep in mind that these are but a few of the amazing foods I’ve had here.

I’ve broken foods down by category, but it’s good to remember that there isn’t much of a difference between lunch and dinner foods. I’m mostly just organizing foods by the meals at which I ate them.



This is a solid example of what I have for breakfast every morning. The right bowl contains  wheat porridge. Untouched, it looks like gravy and has a somewhat savory, peanut butter-ish taste. But add a few heaps of sugar and a splash of evaporated milk and it turns sweet! The left bowl contains fresh, seasonal fruits. That day, I had mango, banana, and pineapple. If you can’t find the pineapple, don’t be alarmed! It’s practically white here, compared to the bright yellow stuff at home. I’ve asked people here why it’s white, but they look at me like I’m crazy when I explain yellow pineapples. Most days I also prepare myself a couple of fried eggs and some delicious (not) instant coffee.


Corn porridge, aka mari kooko! Unfortunately, this was one of my least favorite foods here. It’s made from dried then ground corn mixed with water, forming a paste. That paste is further augmented with water and eventually becomes porridge. On its own, it has a strong, bitter corn taste. With sugar and condensed milk, it is sweet and acidic (not my favorite flavor combo). This is often fed to babies, along with milk and sugar. Thus, it’s often called “baby porridge.”


Waakye! It is pronounced as “watch-ey,” and despite the somewhat slop-ish picture, it’s really good. It’s a mixture of beans and rice, topped with tomato and black pepper sauces. Sometimes a bean is not fully cooked and makes for a delightful, teeth-breaking crunch! Waakye is most commonly eaten for breakfast, although I’m more likely to buy some from the road for lunch. This amount of food usually costs around 2 cedi, or about $0.45!



Grilled tilapia (whole!) and banku! Most any time you order tilapia, this is what you get. Banku is the greyish blob in the plastic bag (super appetizing description there, Anna). Essentially, banku is a fermented corn food used to accompany fish and stews. You rip off parts with your hands and use the banku chunk to pick up the food. The fermented flavor is a bit too strong for some, but it’s starting to grow on me!


Okro stew and banku! For some reason, they call okra “okro” here. The okra stew is a little bit funny. Because of the okra, the stew is slimy and looks a bit like boogers. But description be darned, the stew is good! The okra flavor is strong, and it pairs nicely with the banku. Also, notice the little bowl with water and soap to wash your hands before and after eating!


Red red! The mash mixture in the middle includes beans, gari (dried and ground cassava), and palm oil (aka red oil, due to its red color). The beans are accompanied by fried plantains. (Red oil + red fried plantains = red red). This meal was made at my homestay. (I think my favorite foods thus far have been made at home.) Curious how to make fried plantains my host family’s way (the best way, in my opinion)? Then here’s a recipe!

Fried Plantains

  1. Pour a bunch of vegetable oil in a wok type of pan and boil (you need the oil to form a mini pool for the plantains to swim around in).
  2. Cut plantains into diagonal slices and put in bowl.
  3. Add a little bit of salt and water into the bowl and swirl around with plantains.
  4. Drop the plantians in the oil, and let them cook for about 10 minutes, stirring occasionally.
  5. Add more of the salty water solution if the plantain chunks start sticking to each other.
  6. Plantains are done when red-ish in color with crispy edges but soft insides.



Here I am making fufu with my host mom! (She’s telling me to not worry about accidentally pounding her hand.) Fufu serves a similar function as naan or rice or really any carb accompanying stews. It’s a doughy (seriously, it has the consistency of raw pizza dough) mixture of cassava and plantain flours with water. You pound it in this gigantic mortar and pestle equivalent until it reaches your desired doughiness. One person pounds the fufu, the other mixes the two doughs together so everything is evenly mixed. Fufu is served in a bowl and topped with a soup/ stew, and you eat with your right hand. It’s not my favorite food, and the primary reason for my ambivalence is the fact that you’re not supposed to chew fufu. You scoop it into your mouth and swallow straight away. Any attempts at chewing will earn many laughs from Ghanaian friends watching you eat.


And here is a poor quality picture of fufu covered in groundnut soup!


Groundnut soup! And a rice ball! Aka peanut soup and a rice ball! This is one of my favorite dinners here. So so good. The rice ball becomes an island in a sea of peanut soup, and you eat it with your right hand. (Sorry the picture is a bit horrible. The power went out and my phone wasn’t feeling like taking a decent picture in the darkness.) Lucky for me, I got my host brother, Evans, to teach me how to make it!!

Evans’ Groundnut Soup

  1. Mix peanut butter (about 2.5 cups) with about 1 cup of tomato paste and water


  1. Boil this mixture until red oil covers the top.
  2. Mix onion, ginger, garlic, rosemary, salt, and bay leaves with tomato paste. Mix with chicken chunks (think drumstick, thighs, wings, etc.). Add a bit of water to help coat the chicken. Steam to cook.
  3. Add the peanut mixture to the chicken, and add other veggies if you’d like, like pepper and tomato.


  1. Cook it all until done!

If made correctly, the soup’s texture will be runny and smooth. There should be a slight bite of spice coupled with a slight peanut (but not overwhelming) flavor. The chicken should fall off the bone.

And because rice balls are fabulous, here’s how to make them too!

Rice Balls!

  1. Cook plain white rice (a bit softer than normal).
  2. Mash it up.
  3. Form into balls.

Boy, that was complicated.



Here are fruits at the market! The worst mangos here taste like the best ones at home. The bananas are adorable and look like little fingers. The papaya (called pawpaw here) is unlike anything at home. There’s none of the bitterness that sometimes accompanies papaya. Instead, it is floral and delicately sweet and melts in your mouth.


Here’s a coconut! Coconuts are often sold at the side of the road in carts loaded with them. The vendor chops off the top, and after letting you drink all the coconut water, he chops up the rest of the coconut, letting you eat the meat inside. I think this is my new favorite way to eat coconuts.


In case you haven’t gotten the gist yet, carbs are a big deal here. A huge serving of carbs accompanies every meal, and oftentimes, those carbs take the forms of yams. But the yams here are not the sweet potato equivalents from back home. See those huge brown things in this picture? Those are the yams. And rather than being sweet, they’re starchy and dry and bland. They’re often served boiled or as fries (called yam chips).


Bowl Float! This lil cutey is basically a donut. It gets its name from the fact that the little ball of dough floats in the bowl of boiling oil. You can buy them for 1 cedi at the roadside, less than $0.25. They are slightly sweet, but the texture is far better than regular donuts. Somehow it’s lighter and more cloudlike than donuts back home.

Apparently, people usually eat this with peanuts, although I have not done so.

 A few notes about other foods!

Dairy: Dairy isn’t all too common here. Normal milk isn’t really a thing here, but evaporated milk is. Evaporated milk is served with breakfast cereals and coffee. You can buy packets of it from roadside vendors. Yogurt, cheese, and ice cream are all pretty scare. If you want some ice cream, though, you can sometimes buy a packet of it, called “FanIce,” from a roadside vendor or gas station. FanIce tastes a bit like marshmallow fluff turned into a very light ice cream.

Snacks: Ghanaians generally don’t snack as often as Americans seem to. Or if they do, they may buy peanuts or mango from hawkers. That being said, it is possible to find crackers and cookies from roadside vendors. I’ve had my fair share of saltine and gingersnap equivalents while here, especially on days when normal Ghanaian food becomes a bit too heavy for me.

Water: Water is a funny one. You can’t drink tap water here, meaning all drinking water is bottled or bagged. The amount of waste produced from all the plastic is somewhat horrifying.


So there you have it, my thoughts on a few Ghanaian foods! Please know that I excluded many other standard Ghanaian foods (like jollof rice, kelewele, and a number of stews) in the name of blog post length and fear of picture overload.  If you’re curious about how these foods actually taste, you should try to make them! Or better yet, go to Ghana and try them yourself! 🙂



^This is a mosquito! It’s booty (not really, but I’m not super familiar with mosquito anatomy) is red because it’s full of blood.

Given that basically everyone in Ghana has or will have malaria at some point in their life (possibly multiple times, too), I figure a malaria post is in order. In fact, if you ask a Ghanaian if they’ve had malaria, they may laugh at you because it’s such a ridiculous question. Of course they’ve had malaria. Silly you for asking.

But in all seriousness, I quickly realized I knew woefully little about malaria, the most common disease in Ghana. Having never encountered malaria firsthand in the US, I always believed malaria was an instant killer, a guaranteed deadly disease. Yet on my first day at my clinical internship at Passion Clinic, one of the first patients I saw had malaria. Upon hearing this diagnosis, I expected a panic within the clinic. And yet, the nurses calmly set up an IV, gave him an injection, and told him to come back soon for another treatment. That was it! It became obvious I had an embarrassingly a poor understanding of malaria.

A key aspect of understanding malaria, at least in my opinion, is understanding the basic biology of the parasite’s life cycle. Understanding the life cycle, and thus the transmission, is key in understanding treatment of the disease.

malaria lifecycle.png

When an infected mosquito bites a human, the parasite (Plasmodium falciparum) first enters the human’s liver. There, it hangs out for about 2 weeks, dividing and infecting more and more liver cells. (At this point, the human host displays no symptoms of malaria.) After about 2 weeks, the liver cells rupture, releasing parasites into the blood. Parasites then enter red blood cells and similarly divide and rupture cells. When a mosquito bites a human and drinks blood containing the parasites, the parasites breed in the mosquito and have baby parasites. This mosquito, rich with baby parasites, can then bite another human, pass along the parasites, and continue to spread malaria. This life cycle is super convenient for transmission of the disease; if multipe mosquitoes bite a person with malaria, all of those mosquitoes can pass on the parasite. It’s hardly a surprise that malaria is so common.

malaria RBC 1.png

^This is a red blood cell full of replicating malaria parasites. Once full of parasites, the cell will rupture, causing the release of parasites into the blood where they may infect more red blood cells.  

malaria RBC 2.png

^This is a ruptured red blood cell. See the little purple parasites moving towards other red blood cells? Once they enter the cells, they, divide and eventually rupture the cells.

If infected with malaria, the diagnosis and symptoms are somewhat surprising in their simplicity. Because more than half of the patients at Passion Clinic come in with malaria, I’ve become fairly accustomed to malaria’s symptoms. Most patients complain of nausea, vomiting, diarrhea, fever, and general malaise. Although I haven’t seen these symptoms personally, more extreme symptoms include anemia, seizures, coma, heart and lung failure, and death. Diagnosis for malaria is surprisingly simple. The patient provides a sample of blood through a finger prick, and the blood drop is placed onto a Rapid Diagnostic Test (RDT) that looks somewhat like a pregnancy test. The lab technician (or whomever conducts the test) then places a drop of a buffer (a solution with about pH 7) onto the stick, underneath the blood drop. The buffer travels up the stick, carrying the blood with it. If the patient is positive for malaria, a red line appears on the stick by the “P.f” marker.


^These are the types of RDTs present at Passion Clinic. The line at P.f. on the stick indicates that the person is infected with Plasmodium falciparum, the malaria parasite most prevalent in Ghana.

Despite malaria’s prevalence, it does not automatically infect all individuals identically. The disease is particularly prominent in sub-Saharan Africa, the Middle East, India, and central America. It accounts for up to half of medical visits in Africa. I have observed this trend at Passion Clinic, as more than half of the patients are diagnosed with malaria.  Because mosquitos spread the disease, the first line of defense are insecticide-treated nets. After speaking with several Ghanaians, however, I gathered that using these nets is not incredibly common. To some, the net is a nuisance, and others find they have a high tolerance to malaria and thus do not require the nets or extra protection against mosquitos. Now, you may be asking, “Goodness Anna, what is this miracle tolerance of which you speak?” But it’s true, some people have partial immunity to malaria. The doctor at Passion Clinic explained that some individuals have this tolerance because their bodies built up sufficient antibodies over the years to handle, to a degree, the parasites. So, some may have the parasites but symptoms don’t manifest. Someone like me, however, with no history of tolerance to malaria, would become seriously ill if infected with malaria. Thus, even in zones like Ghana, where malaria is especially prominent, the disease does not affect all individuals identically.


^This is my bed and my beauteous net! Even though I put up it somewhat haphazardly, it does the job!

Treatment of malaria is also straightforward, in the cases I have seen, although several factors may inhibit individuals from acquiring proper treatment. The disease affects children and adults indiscriminately, though treatment for children is much more urgent than for adults. This is because children’s immune systems are generally weaker than adults’ and thus children are more prone to malaria’s fatal symptoms. After diagnosis of malaria, nurses administer the first dose of an anti-malaria injection. The patient also receives anti-malaria pills, to be taken orally, and is advised to come in another two times for the remainder of the anti-malaria injections.  This process is similar for adults and children, although children are given an anti-malaria syrup instead of pills. The injections and pills form the recommended line of defense against malaria, though not all patients desire or can afford such treatment. In many cases, the patient may choose to solely receive the injections or the pills, rather than receive both. Another inhibitor to treatment is accessibility of medical care. Individuals living in rural areas with extremely limited access to medical care simply may not have access to malaria treatment. In these cases, the disease has the opportunity to flourish and kill. Thus, while treatment is relatively uncomplicated, inaccessibility of treatment prevents individuals from receiving proper care.

The reason malaria becomes deadly has to do with the disease’s parasite. There are actually four types of plasmodium that cause malaria, but only plasmodium falciparum kills. This is because the parasite has a “sticky” protein that makes red blood cells to stick together, causing blocked circulation and micro-hemorrhages. As you can imagine, this is particularly dangerous for the brain and the placenta of pregnant women. If the brain and placenta don’t receive oxygen from those red blood cells, these organs die (and the baby, too). Furthermore, the fevers, specifically those caused by the deadly yet common parasite Plasmodium falciparum, may infect the brain and cause cerebral hemorrhages and death. These are so dangerous to children under age 5, and in fact, about 77% of the 367,000 – 755,000 annual malaria deaths occur in children under five.

micro hemorrhage.png

^See those little brown dots on the brain? Those are micro-hemorrhages of cerebral malaria.

Although malaria is preventable and treatable, several factors account for the breadth of its spread and fatality. Natural resistance to the disease may be present in some individuals, although simple preventative measures, such as treated nets, are always recommended. The symptoms are straightforward and common, as is diagnosis and treatment for the disease. Despite this prevalence and relative ease of treatment, socioeconomic factors inhibit proper treatment, resulting in the fatal effects of the disease. Stunningly, a preventable disease as internationally recognized as malaria remains a potent killer.

I feel like I should give you a pat on the back for reading all of that! Kudos to you! And because this post was heavy and somewhat technical, here’s something funny to lighten the mood! A couple of my host sisters, Ewuradwoa and Maame Yaa, asked to do my make up a couple of weeks ago. I think they did a fabulous job.


^Maame Yaa and me before the makeover!


^All three of us after!

Holy Hazelnuts and Jesus Slide Shows!


^One of my host brothers, PK, and me after church!

Just as a preface to this post, know that my observations of Ghana’s religious practices form just a fraction of the religious reality here. I’ve been primarily exposed to Christian practices in Accra, and so my post will focus on my experiences thus far.


^The back of a trotro wearing the phrase “Trust God.” It is not uncommon for trotros and taxis to have such religious sayings adorning the windows. 


Ghana is a primarily Christian country, though the Northern region has a larger Muslim population. From my observations thus far, some traditional Ghanaian religious elements merge with Christian ones to form a dynamic belief system. These beliefs, coupled with the popularity of Christianity, make for an extremely religious society.

I’ve witnessed the everyday popularity of Christianity a couple of times at the clinic. I brought the staff a little present from home, just a bag of hazelnuts. When I presented it to a nurse, she immediately expressed her gratitude, held up the gift, said a prayer of thanks, and ended with a passionate “Amen!” from her and the other nurses. And another day, I saw a nurse playing on her phone. I asked what she was looking at, and she joyfully presented me with a slide show of pictures of Jesus. I have to admit, her excitement about the Jesus slide show was a bit infectious. 🙂

My Church Experience


^The road outside of church. If you look closely, on the left hand side of the road, there’s a sign reading “Presbyterian Church of Ghana.” The stand is outside of the English/ French/ Ga church.

I observed a service at the Presbyterian Church of Ghana, my host family’s church. There are multiple branches of this church in Accra, and we attended the English/ Twi service (as compared to the English/ French/ Ga service). Mass took place outside of someone’s house, I believe, underneath tents and the house’s veranda.

The congregation was primarily older, with some younger people and families present as well. Kids went to a classroom to do their own thing, like listen to songs and read their own versions of that day’s pertinent Bible passages.

Church here usually takes around four hours, from 9 am to 1 pm. My family, like typical Ghanaians, arrived at 10 pm, a whole hour late! I don’t think we missed a ton though; it seemed like that first hour was devoted to song. The music set up was interesting: some young people (including one of my host brothers!) had microphones, and there was a keyboardist, a guitarist, and a drummer. Basically a lil band! I couldn’t help but notice that people sang much more heartily than at Catholic masses I’ve attended back home.

The service was organized as such: songs, discussion groups, hymns, bible passages, the pastor’s homily/ sermon, welcoming of visitors, celebration of birthdays, general announcements, donations, communion, and a closing song. Whew! Just a few more elements than what I’m used to. So, now to break the different sections down!

Discussion groups:

I really enjoyed this element! Each group was given discussion questions that related to that week’s theme. The week I attended, the theme happened to be sin (at least I think. I just know they talked about sin a whole lot). The discussions lasted for about 30 minutes. Although my group primarily discussed in Twi, every now and again they would pause and summarize sentiments for me in English.

Bible passages and Sermon:

I’m thinking these two sections account for mass’s length. The bible passages and the sermon were given in both English and Twi. The sermon, lasting for about 30-40 minutes, felt a bit more formal/ stiff compared to the Catholic homilies I’ve heard (or maybe I’ve just heard homilies from pretty chill priests). This sermon heavily emphasized sin and the rejection of sin. What caught my particular interest was his mention of the sin of same-sex marriages. I knew that same-sex marriages are illegal in Ghana and that society here is largely intolerant of homosexuality, but it still caught me off guard.


^A view from my position during church. They maintained the cross shape seating arrangement, even in the outdoor venue!

Welcoming of Visitors:

Boy, were they welcoming! That was hardly a surprise, though, as the spirit of welcoming is an important social custom in Ghana. Here, it is standard to hear “You are welcome” or “Akwaaba” when entering a space. (The lack of welcome is seen as an offense.) So, it was hardly a surprise to learn that the church welcomed visitors with a similar enthusiasm. They invited all visitors to the front of church, and the elders of the church shook all of the visitors’ hands and welcomed us.


The process of donations seemed to exert far more peer pressure than what I’m used to. The donation bins, all arranged on a large cross, were placed at the front of the congregation. One by one, people proceeded to the bins to make their donations. It became pretty obvious who did and did not donate. That being said, though, people seemed quite excited to get up, shuffle to the front, and do their part to improve their church.


At first, I wasn’t sure if I was allowed to receive communion. I know I can receive communion at Catholic services, but I wasn’t sure how Presbyterians do things. But after confirming that I’m Christian, a few elders urged me to take communion. I guess being Christian is all it takes! The wine administration was pretty different from what I’m used to as well. They served it in little, individual cups, almost like mini shot glasses!


^Some churchgoers talking after mass. The ladies tended to wear traditional Ghanaian patterns and styles. 

Of course, this is but a brief overview of my observations of religious practices in Ghana. There are many more complexities, especially when taking the traditional Ghanaian religious beliefs and presence of Islam into account. And while the blatant popularity of Christianity here, in all aspects of life, catches me off guard sometimes, I can see why some call it a pop culture movement. Its relevance across all age groups and pervasiveness into daily life, from praising hazelnuts to Jesus slide shows, certainly makes it pop. 😛

Ghana’s Health Care Delivery System, ft. Passion Clinic!



Hello again!

One of my primary goals in studying in Ghana was to understand the country’s health care system, and lucky for me, one of my classes is called Health and Society in Ghana! How handy! And so, this blog post is a bit of a regurgitation of what I’ve learned in class with a splash of connection to my medical internship.

Ghana’s health care system is broken into several different sectors: the public sector, the semi-public sector (run by public entities), the religious-based sector (mission hospitals), the private sector, and the traditional sector. Of most pertinent interest to me is the private sector, as I intern at a private clinic.

The private sector includes healthcare facilities owned privately, usually by individuals. These facilities are mostly urban-based, and they receive minimal support from the government. Though managers don’t like this designation, they are known as “service for profit” or “fee for profit” sector. These types of facilities include hospitals, clinics, maternity homes, pharmacies, and medical diagnostic labs.

I work at Passion Clinic, a relatively small yet mighty clinic located somewhere between Accra and Madina. The clinic boasts surgical, medical, pharmacy, and laboratory services. It has one two doctors, though one is in America right now, a handful of wonderful nurses, laboratory workers, and a pharmacist. The clinic cannot provide the full and complex services that, say, the public military hospital (the largest and most well-equipped hospital in the Greater Accra Region), but it can provide most family care and communicable disease care services.


^The outside of the clinic.


^The view from the doors of the clinic. That blue contraption is a hand washing station. The two doors with gates lead to the laboratory and the pharmacy.



^Inside the clinic. To the right is the nurses’ bench, and the table to the left is the administrator’s bench. Also to the left are the labor rooms and wards.


^The clinic waiting room. This is where I hang out until patients arrive. Behind the curtains are the primary treatment rooms and the doctor’s office. To the left is the nurses’ bench.



^Some of the many posters inside the clinic’s waiting room.


What sets Passion Clinic apart is its somewhat unique licensure to perform a variety of family planning services and procedures. It can provide birth control (in all its forms, and in forms I didn’t even know existed! As in, did you know there’s a shot, called depo, that simply prevents pregnancy for 3 months?? How wild!) and it can even perform abortions (although this happens extremely rarely, as Ghana is a firmly pro-life country). Passion Clinic provides these otherwise rare services because of its certification from ­­­­Marie Stopes Ghana, a Planned Parenthood equivalent. Consequently, many patients here are empowered to begin families when they’re truly ready. It’s pretty neat knowing I am working at a place that encourages women in that way.


^Me pointing to the family planning services list. In case you couldn’t tell, I’m pretty excited about reproductive empowerment. 🙂

I’ve seen these family services performed several times already, and boy was that exciting. I’ve seen birth control implants removed and inserted, and I’ve seen the administration of the depo injection. And on the flip side, I’ve seen many pregnant women, excited about their growing families, come in for standard checkups. I even palpated one woman’s baby bump (with her consent, of course) and felt the baby’s head!! I also observed a nurse explain the birthing process to a very pregnant woman, and seeing the nurse empathetically and directly explain the dilation of the cervix, discuss the importance of breathing through the pain, and address any concerns was incredibly inspiring. I hope to be such a steady medical practitioner someday.

I know there are oodles more to learn about Ghanaian health care, but I hope this is a sufficiently brief overview of the system and its relevance to Passion Clinic. Yet with a bit more digging, I hope to have a greater understanding of the health care system I work in. And who knows? Maybe understanding Ghana’s system may help in getting a better grip on our own messy system.

Also, this picture is completely unrelated, but I found it too cute to not share.

These cats are pets at my homestay! They’re a bit different from pet cats back home, though– they live outside and are a bit wild. I think there are about six of them, all family. They’re small and boney and skittish but oh-so-cute.




My Greatest Worries and My Bucket List (and their Ironic Coexistence)

Hello world!

My first blog post–how exciting!

I thought it would be fun to create a bucket list of sorts, things I’d like to experience and gain from my time abroad. I also thought it would be fun to talk about my biggest worries for studying abroad. Funnily enough, I realized my bucket list and biggest worries list share quite a bit of overlap.

Once I’m back in the states, I’d like to revisit this post and talk about what I crossed off my bucket list/ worry list, how I managed to conquer the item, and any other reflections that could be fun to offer.

And so, let the listing commence!

Flying Internationally Alone

I think this is a perfectly rational apprehension. Who knows what could go wrong? Making matters worse, I am rather susceptible to ignoring my surroundings and paying little heed to where I’m going. (Kinda funny, then, that I thought it would be a grand idea to study abroad. Maybe I’m trying to teach myself how to swim by jumping in the deep end?)

That being said, however, it will be incredible knowing I can fly internationally (!!) solo. If I can conquer this, I can do anything! (Maybe. Or maybe I’m just telling myself that.)


Transportation in Accra

From what I’ve heard, common transportation in Accra consists of tro tros, minivans that run on set routes around Accra. They often are quite crowded, and it takes some elbow grease to shove yourself into a packed tro tro.

While I know I’ll quickly get used to riding tro tros, the initial learning curve gives me a slight amount of grief. What if I’m overcharged? What if I miss my stop and end up someplace I don’t want to be? What if I get on the wrong tro tro, end up somewhere unfamiliar, and don’t know how to get back? I know I will most likely find myself in several of these situations and I’ll only emerge stronger, but still, what if??

But similarly to the international flying business, I’d be quite proud and excited to ride a tro tro with confidence. The knowledge that someone like me, someone dorky and occasionally oblivious like me, can handle a tro tro is pretty neat. For that alone, it’s a pretty deserving bucket list item.

Working in a Medical Capacity

This is my life goal, right here. This is what drew me to the program in Accra. I am beyond excited for my internship. Although I have little idea of what to expect (I don’t even know my placement right now), I can’t wait to see where I end up. The internship is like the cream of the crop of my bucket list.

But as with any medical profession, there’s always the fear that you’ll do more harm than good. I may have the best of intentions, but taking a risk with others’ health gives me pause.


I don’t mind the bugs themselves. I rather mind the bites (and consequent illnesses) they may give me. Mosquitos, in general, are particularly undesirable, but the knowledge that Ghanaian mosquitos carry all sorts of fun things like yellow fever and malaria only enhances my distaste.

Of course, I’ve had my immunizations and I’ll have anti-malarial pills, and you can bet that I’ll always carry the oh-so-pleasant aroma of DEET, but still, those mini-vampires will find me.

Now, you may be asking yourself, “Silly Anna. How do bugs relate to your bucket list?” And to that I respond, assuming I don’t get malaria or yellow fever, enduring those bug bites will be a sign of victory. I will proudly wear those bug bites. They will be a sign that bugs can bite me all they want, but sick is not what will become of me. Overcoming bugs is totally a worthy bucket list item.

Ghanaian Food 

This is more of a bucket list item than a worry. I mean, if you know me at all you know that I get a bit lovey dovey with food. The opportunity to try Ghanaian food leaves me starry-eyed. The opportunity to try Ghanaian food with my host family every day? I could weep.

Of course, there’s the worry that, for some obscure reason, I won’t like the food. Maybe it will be too spicy, maybe my body will freak out and suddenly decide it’s allergic to everything, who knows. (Seriously hoping that doesn’t happen, though. I would be heartbroken.)


There you have it! My greatest worries and excitements for my time abroad, all in one little list.

I believe my mindset will be one of the most influential factors on my time in Ghana. This relates a bit to the title of this blog post. My greatest worries for this trip are also the things that excite me the most, that I most earnestly want to experience. They may be scary, but that’s all part of it.  A teacher once told me it’s not particularly wise to start a new experience with a set of expectations. Those expectations will determine the outcome of the experience, rather than letting the experience develop naturally. And so, I shouldn’t have a set of expectations for my internship, the raucousness of tro tros, or even my enjoyment of Ghanaian food, because in all honesty, I have little idea of what to expect. I can research the city and prepare for worst case scenarios, but ultimately, my time there will be unique.

So really, my greatest worries and my bucket list aren’t too different. I just need an open mind and a willingness to adapt.