If you find no fish ... (English version - De Nederlandse versie staat hieronder :) )

26 augustus 2018 - Kumasi, Ghana

When I told my family and friends that I wanted to go to Ghana, they always asked me to come back safely and healthy. But being 'healthy', what does that mean in Ghana?
Can you stay healthy by eating a mango, sleeping under a mosquito netton and washing your hands? Or should you be lucky having favourable genes? Can you stay healthy by being motivated and having adequate knowledge? Or do you just need a lot of money to be healthy? Can everybody be healthy, or is it a luxury? 

I do not think that there is a very clear answer to these questions, but one thing I do know is that it is very important to keep going, no matter what. There is a Ghanaian saying which explains very well how a lot of Ghanaiens cope with their problems: ‘If you find no fish, you have to eat bread’. It means that life isn’t always easy, but we have to accept this and try to take the best out of it. There are many things that we cannot control, but we do have control over the way we react during bad moments. You could give up, or take a moment and then move on knowing that better times are coming!
When I sit in a trotro, driving through the city of Kumasi, I always see the same man. His legs were amputated and he found out his own way of ‘walking’ on his hands. He always walks on the busy road and tries to sell his products. Do you think he is an 'unhealthy' person? Maybe not. 

When I came here, I also had some things that I found difficult to cope with. I had some problems with my accommodation and the internship was not as nice as I expected. I have been upset for two days, but after that, I tried to make the best out of it. I started to work at a very small maternity clinic. There were little resources, but the staff was always very willing to explain everything to me and I had a very positive experience. In the meantime, I worked very hard to organize an internship at the obstetrics and gynecology department, because I am very interested in this field of medicine. It took a lot of effort, but I am so happy with this internship. If you keep calm and eat your bread, you will finally get your fish ;) 

My first week at obstetrics and gynecology was very impressive. I saw many deliveries and C-sections, which was so interesting! However, I was also a bit shocked when I realized that in Ghana you really need money to receive good healthcare. In my country (The Netherlands) it is very normal that doctors try everything for every patient to help them. In Ghana, doctors need to know first whether their patient is able to pay for the treatment or not. Outside of the hospital, many people are lying on towels, because they can’t afford a hospital bed. People told me that a child died of an asthma attack, because his parents didn’t have enough money for oxygen treatment. When a pregnant woman was examined by ultrasound, the doctor found out that her child had already died. The first thing that se wanted to know was how much she had to pay for the treatment. 

I don’t know If the people I described above feel unhealthy or think they are in a bad position, because some situations may be normal here in Ghana. However, as a western student who just started to work in a hospital for the first time, I was very touched. I started to think about why I came to Ghana. Wouldn’t it have been better to donate my money to Unicef instead of coming to Ghana myself. Maybe, but for me it is very helpful to think about my original goal of coming to ghana, which is an internship. I went to Kenya and Uganda as a volunteer, but I came to Ghana to learn a lot about medicine and how it is practiced in Ghana. I think that it is a good thing to see how people live in Ghana and how little resources they have. It really motivates me to keep studying, change my lifestyle and maybe coming back when I am a real doctor. Until that time, I just try to enjoy every moment and learn as much as possible. I always try to respect all patients, doctors and everyone I meet here and see if I can learn something from them. 

Of course, I want to help everyone I meet and of course I want to make a difference. But even in the Netherlands, I cannot help everyone and I cannot make a big difference every day. But I like to focus on what I can do, rather than what I cannot. I can be interested in other people, have a good conversation or try to encourage patients to keep trying. I can make jokes, make people laugh or cook a nice meal. There is another African saying: ‘If you think you are too small to make a difference, you haven’t spent a night with a mosquito’. I think this is true. There is always something you can do to make someones day a little bit better, so that is what I will always try to do. 

Although I had some troubles, I really really like Ghana!! It is such a nice place to have my first experience of working in a hospital. When I am here, I feel appreciated, just by being here. In the Netherlands, many people have a lot of stress, you always need to perform and reach your goals, people are in a hurry and there are protocols for almost everything. I you ask people in my country how they are doing, a common answer is ‘I am busy’, instead of ‘I had a great day’ or ‘I am fine’. In Ghana people really take their time to stand still and reflect on what they are doing. This makes me feel more relaxed and less worried about making mistakes. I just like walking on the street, seeing so many people smile!
It is a lot of fun to get to know other cultures, taste new types of food (spicy!!) and spend my time with people from another culture. Yesterday I went to the athletics station with my housemaid from Ivory Coast. She always makes me laugh so hard and her positivity is a great inspiration for me. 

I think that it is clear now that a big bag of money could be very useful if you want to stay healthy in Ghana. But what if you don’t have that much money? In that case you could try to see ‘being healthy’ in a broader perspective. Being healthy is not necessarily the absence of disease, having no pain at all or not being obliged to spent a night on a towel next to the hospital. You can also try to see ‘being healthy’ as a physical and mental state that is good enough to take part in daily life and be happy. If you don’t have legs, you can still enjoy the music, the mango’s and the people around you and try to walk on your hands. People who are suffering are not necessarily unhappy in all aspects of life. The patients lying in front of the hospital still have family, friends and maybe children. There is always something that can make you feel happy! 

I absolutely don’t want to state that the circumstances people are living in are not bad or heavy. I was very shocked by seeing the circumstances that I described above! However, I think that it is a very nice lesson to remember that there is always something to be happy about and better times will come! Until that time, just keep calm, eat your bread and try to focus on what makes YOU happy :) I will try my best!