Can you say "Fresh"?

There is a juice company here called Blue Skies (http://www.blueskies.com/). It's some of the best juice I've had. In fact, it's the only juice I've ever had that tastes as good as if someone made it for you that morning. You never know with this one; that could actually be the case. Blue Skies does not use any preservatives, so it's bottled here in Accra and brought directly to the supermarkets. Here's a picture of the expiration date from the one I had just a few hours ago.

I have no clue what the usable window is for something like Nantucket Nectar, but I've got to believe that it's longer than one week. This juice makes everything else look (and taste) like the Twinkie version of juice. And there's no joking about this expiration date. I bought one a few weeks ago and put in in my refrigerator overnight. As my Ghanaian experience level at that time was n00b (read: complete beginner), I didn't think to check that the refrigerator was even on. This was just one of the things in my first week here that brought laughter to all those around me - hey, at least it made someone happy in the process.

So anyway, leaving your Blue Skies in an unrefrigerated refrigerator is not a good choice. I went to drink it the next day and it was like a sour pineapple smoothie. No bueno.

I wish this had a better shelf life so I could bring some home with me, but I guess that gives you one more reason to visit Ghana!

My Life as a Meme

I'm thinking of having a semi-regular feature here called "My Life as a Meme." For better or worse, I find myself thinking in memes these days. Here's the first installment.

There's not much to be done at this point. They're attracted to my bed sheets, my comb, my soap, my shoes, and just about everything else. They were here when I arrived and they will be here when I leave. I take my comfort in knowing that our tenure as roommates will come to an end in a matter of weeks.

Getting away from the ants, there has been something that I've wanted to share since last Sunday. When Michael, the main student researcher with the program, came several weeks ago he introduced me to Mama Mia's, an Italian restaurant in the Osu neighborhood of Accra. You see more Obrunis (white people) in there than you do Ghanaians, but the quality of the pizza is amazing. Until last Sunday I had to take any comments about the quality of the pizza on good faith. It happens that the one time I went Michael was the first time my stomach decided to protest so I had plain spaghetti with diced garlic... still a surprisingly exciting break from rice!

Last Sunday my faith in the quality of the pizza was replaced with the cold, hard truth. Or soft and gooey truth, as the case may be. As I tried to navigate the side streets of Osu I felt like I was looking for Mama Mia's in all the wrong places. I even thought about giving up and returning to the grilled talapia stand by Duncan's. (Tested before and proven to be quite delicious - a very attractive back up plan.) Perseverance paid off and I ended up finding the restaurant. 

The pizza was truly delicious. I ordered the Peter Pan and realized when it came that I should have brought my camera. I think there were four or five different meats, all of which shared no resemblance with chicken or goat. (There's been too much of that these past weeks.) The pizza could have fed two, so I took the unfinished portion to go and gave it to the porter when I arrived back at my residence. I would have loved to finish it myself, especially as it was a bit of a pricey meal, but remember that ant problem I discussed above? Either way this pizza was going to be someone else's dinner. My choice was whether the recipient would be the ants or the porter.

As I was paying the bill I noticed the waiter walking by with several very small cups. Was this really what I thought it was? It couldn't be - not here! I asked, "Was that espresso that you were carrying?" Before he could finish saying yes, I asked him to bring one to me. I then proceeded to get as high as a kite on concentrated caffeine. Was this a smart choice at 8pm before a work day? Probably not. Was it delicious? You can bet your boots it was. And it certainly beats my standard Nescafe.

Though Nescafe has almost become a thing of the past for me. Now I'm on to bigger and better things. Instant coffee? Who needs that. Instant cappuccino? That's more like it.

You might ask, "Does it even taste like a cappuccino?" And my response...

Why I Love Hiking

Life has felt a little hectic lately. I've been busy with work and have also had a few other things on my plate. The combination of it all makes it all seem a little overwhelming. I just recently was able to look at one part of my workload and say, "Andrew, you're all caught up with that." It's amazing how finishing one thing can also lead you to realize that all the other things you had in your mind weren't all that big either. It's as if passing some critical point in terms of workload makes everything exponentially worse than it truly is.

I've been moving steadily through the first book of Game of Thrones and that's been pleasant. The last 24 hours have brought with them a rather unpleasant stomach bug, but things seem to have cooled down. This is the price you pay for paying $1 for dinner at the Night Market. The food is decent, but I guess it can't be perfectly germ-free all the time.

As I've felt a little overwhelmed with life this summer, I've been trying to step aside from my daily routines and think about the things in life that I enjoy the most. Perhaps the first of these to come to mind is hiking. I feel odd saying this, because hiking and I did not start out on very good terms. In fact, I wasn't a huge fan of hiking as a child. My dad would say that we were going for a hike and it almost seemed like a chore. My how times have changed, and for the better I ought to add.

I've been lucky in that both my parents are avid hikers. My mom has been to the bottom of the Grand Canyon more times than I can count and she still manages to make it back there at least once a year. As I mentioned above, my dad was one of the first motivating forces behind my hiking. As a kid that might not have been the most exciting, but now it's great to know that we both have that interest in common. There's are actually a few great hikes near where we live in Massachusetts and we were able to make it out to one the last time I was home.

The real treat that I had with regards to hiking came the summer that I spent as an intern at the World Health Organization in Geneva, Switzerland. Let me share a few pictures I took from various hikes during that summer.

The first three of these photos come from a hike that I did up La Tournette, a mountain that I believe overlooked a town of the same name. I did this hike and several others with a hiking club that I became acquainted with in the area. You would not believe how much those people could hike! I know I have photos somewhere around here from another hike that I did with them. Oh, here we go...

If you look closely, you can see just how steep that hike was. Add to it that the Lake Parade in Geneva was just hours before and you'll understand me when I say: this was the most difficult hike I've ever done in my entire life!

Ok, back to the first set of pictures. Like I said, the first three were with this hiking group. The fourth photo is actually from the first time that I ever hiked up Saleve. In Mary Shelley's Frankenstein the creature flees up the rock face of Saleve upon its escape. 

That's not a photo from one of my hikes, but it gives a good idea of just how steep the rock face is. My first time hiking, which is when I snapped the photo, we took the long way up, which was significantly more relaxed. I returned to Saleve many times in my time in Geneva and decided to stick with the steep trail. I even had the privilege of taking my parents there when they came to visit me. Anyone looking to verify just how steep of a hike this is, you can ask either of them. One of my favorite parts about hiking Saleve is that it is accessible from public transportation. Just jump on that #8 bus and you're good to go. I think this is part of what made Geneva such a special place for me.

The last photo of that first bunch should make your mouth water. If it doesn't then your taste bugs haven't been configured properly. After a long hike with some co-workers we arrived at a farm that rested atop the mountain. This was the dish they brought us and it made every drop of sweat worth it.

Why do I love hiking so much? This might be a question that doesn't really need explanation. How could you not like hiking? It takes you outside of the city and puts you back into nature. It gives you a chance to either be alone with your thoughts or do something relaxing (but sometimes incredibly challenging) with your friends. There's really nothing like it.

There's something fishy here...

Let's start things off with a picture I took yesterday at the All Needs Supermarket.

Wait... what does that say?

This is Mamma G's Special Shito, a spicy sauce typically served on the side of any rice-based dish that you order. You find shito everywhere. Its composition makes it stand apart from other spicy sides. It gets its kick from cayenne pepper, but beyond this kick there is another flavor that can catch you off-guard if you're not careful: fish. While shito is about as common in Ghana as ketchup in the US, every household here prepares their own shito and the result is never the same. If you're like me and you love a good hot dish, then the days when the shito is spicy are a pleasure. The problem for me is that I don't really like it when my chicken tastes like fish, or when rice tastes like fish, or when the air I'm breathing tastes like fish. And that's a fact of life with shito. Some days it just tastes like Long John Silver's underpants.

Shito is hardly the only place where Ghanaians like to sneak in a little fish. I've actually found fish bones in just about every dish I've ordered here. For some (mostly Ghanaians, I imagine) this must be paradise. For me, it can range from just a little confusing to a bit of a meal-destroyer. It all depends the exact strength of the fish.

What it feels like

Some people don't like fish. I've always known that my dad is not particularly keen on it, but I've also recently discovered that my two brothers aren't big fans either. I love fish, or at least I thought I loved fish before I saw just what real love for fish looked like. There is a time and a place for everything, and it seems like the Ghanaian approach to fish is "always" and "everywhere." I just can't keep up.

There are ways around fish-overload. Find the places where the shito is typically more spice and less fish, but even that isn't a definite guarantee. Avoid the dishes where fish typically sneaks in, such as Red Red. (This dish is amazing when it's not too fishy. I'll try to get a photo up soon.) This is also a good place for reflecting upon the quote I used a few posts ago: If you can't stop the waves, so sailing. Little by little, I'm trying out the fishier side of life. With a little more than a month to go, you never know where I'll end up.

Maybe before coming home I'll be on par with the DrPH student working on the same project. On one of his last nights here, I saw him remove a fish head from the body (already dead and cooked, of course) and suck the brains from its skull. Even writing this makes my skin crawl. He also commented on the fine taste of the eyeballs.



Get some more Shito information here: http://www.efiashito.com/whatisshito.html.
The boxing fish picture came from http://www.cardmine.co.uk/list24/a240574.jpg.

Some webcomics

Sometimes you're surfing the web and you find something that really speaks to you. Lately I've been too stressed with my life pulling me in what feels like a million different directions. Check out these comics and tell me you haven't felt the same way before.

http://www.phdcomics.com/comics/archive.php?comicid=1503
http://www.phdcomics.com/comics/archive.php?comicid=1504
http://www.phdcomics.com/comics/archive.php?comicid=1505

It's good to know that I'm not the only one who feels like every second of the day I need to be either checking my cell phone or my e-mail to see what tasks needs my attention.

While I'm mentioning comics, let me mention another that I check regularly. The first is XKCD, which titles itself as, "A Webcomic of Sarcasm, Romance, Math and Language." Here are links to a few favorites of mine.

http://xkcd.com/1054/
http://xkcd.com/539/
http://xkcd.com/936/

Busy day at work so that's all I've got time for today. Will be back soon.

“If you can’t stop the waves, go sailing.”

As promised, I’d like to take a minute to explain why exactly I’ve decided to write this blog. If I can clearly articulate what in my mind is a rather cloudy set of ideas, then it could be worth reading. Before I take on that task, let me give some quick updates.

After my last post I was true to my word and set about doing an in-room yoga workout. I was this close (makes the “this close” gesture with his hands) to skipping the workout entirely because some friends had called and said they just arrived at my building. Luckily there’s a little restaurant/bar at the ground level so I told them to occupy themselves for half an hour and then I’d join them. It felt great to get into yoga again and I learned two valuable things. First, yoga mats are entirely underappreciated. The hard tile floor is unforgiving, especially once you begin to sweat and you find its difficult enough keeping yourself from sliding around, let alone following along with the routine. Second, it will take some dedicate regaining my old flexibility. It wasn’t until I came face to face with steps in the practice that would have one time been easy that I realized how I’ve become, dare I say, a little out of shape. I was discouraged for a moment, but at least I know it was possible for me once so it’ll be possible for me again. Just have to keep at it!

I spent most of Saturday and Sunday pouring through the virtual pages of The Year of the Flood by Margaret Atwood on my Kindle, a quotation from which I’ve borrowed as the title of this post. It’s the second book in a series that began with Oryx and Crake, one of my personal favorites. I enjoyed the sequel, but not as much. Just between you and me, I was so eager to finish the book because I’ve decided to take on the mammoth series A Song of Ice and Fire, by George R.R. Martin, which you may recognize as the basis for the popular HBO series A Game of Thrones. Using page count as the simplest measure of length, the current series is nearly five times as long as the combined books of The Lords of the Rings. I’ve got my work cut out for me.

Now, let’s get to the real reason for the post. It’s going to start very nerdy and we’ll just have to see where it goes from there. Do you remember the advice Bilbo gives to Frodo early on in The Fellowship of the Ring? I’m sure you do, but it’s copied below just in case. 

“It's a dangerous business, Frodo, going out of your door," he used to say. "You step into the Road, and if you don't keep your feet, there is no knowing where you might be swept off to."

Going out the door may be dangerous, but it’s this sense of adventure that makes it so rewarding. I’m at a point in my time in Ghana where I’m starting to really take in all the great things about this experience. This blog is where I hope to reflect on what I'm up to. Hopefully it will survive this summer and become a regular fixture in my day-to-day life. 

The other motivation for this blog comes from a desire to have a space where I can be transparent with myself and with those around me about whatever catches my interest. I've had some good moments here in Ghana to reflect upon life in general and I'm hoping that I put these thoughts together into a format that makes sense and share them on here. Right now things are in their early stages and they're likely to stay there for some time, but stay tuned and we'll see where things go.

Anyway, we've just lost power in the office so that seems like it may be my signal to wrap things up. The good news it that the generator has come on and everything is working just as it should. The bad news is that no such generator exists back in the dorm. Time to break out the ol' flashlights.

Take the long way

I’d like to introduce you to some of my friends here in Ghana. (Mom, don’t freak out as you scroll down. I promise I have real friends too.)

First we have hand broom and dust pan. Better quality bristles than I found on brooms in Mexico, but that’s hardly relevant. I bought these items last week at the mall and have used them twice to sweep out all the dust that blows into my room. In fact, the second instance of this sweeping happened just moments ago and was the inspiration for pulling out the laptop and jotting down my thoughts. Do you know how long it takes to sweep an entire room with a hand broom? Here’s a picture of my room so you can get an idea. Not small by any means. (More on my living situation in another post.) 

I’m sure that by any historical measurement or non-“I-grew-up-in the-USA” measurement the time that I just spent cleaning seems microscopic. For me, it provided me just enough time to get into it and actually feel connected with the floor. Now you might be asking yourself, “How much dust did he inhale that he’s now becoming one with the floor?” Something in the act of being down on my hands and knees (Did I mention it’s a hand broom instead of paying $1 more for the full size? Travel thrift is in my genes.) crawling a few inches forward after each brush really felt rewarding. Now my floor is clean enough to do yoga, which is just the plan. We’ll see how that goes.

Next we have something I’m sure you’ve all seen at some point or another so it hardly needs an introduction. If you’ve been following me on Facebook, you’ve seen my posts about how handy this little guy can be for opening wine bottles. I’m actually only 2 for 4 on that count, but I’ll share the disaster photos another time. When you look at this doesn’t it just scream, “I’m a problem solver!” In addition to helping open the odd bottle of wine, it was also instrumental in helping put together the fan you see in the above photo from my room. 

Next we have a set of items that probably look familiar, but how about that razor? About two years ago I decided I was going to ditch disposable razors and switch to this little guy. It’s called a safety razor and my inspiration for it came from a section of a book titled “Shave Like Your Grandpa.” All said and done, I think I shave just as fast with this as I have with anything else and the upkeep is so much simpler. Just replace the razorblade and you’re good to go. There’s another cool thing about it, you get to deal with super sharp equipment and feel like Mr. Manly Man every time you shave.

I’ve saved the best for last. What are these? Obviously we’ve got two buckets and maybe you can identify the electric kettle, but what on earth do they have in common? Ever heard of a bucket bath? Maybe you have and I’m the only one who’s new to this. I’ll explain anyway. Every morning when I wake up, I use the little bucket to first fill the electric kettle and then turn it on. While the water is heating, I use the smaller bucket to fill the larger bucket with water from the sink. Once the water has reached a boil, you add it to the larger bucket and hope that the mixture is neither too hot nor too cold (Imagine Goldiocks picture), but there are easy fixes for that.

So why am I sharing all of this? Partially because right now, typing up my thoughts is more fun than figuring out how to do yoga on a cold tile floor, but also because these things make me feel more alive. I mean it. It’s not that any one of them is an essential cornerstone to enlightenment, but they force me to turn off the auto-pilot of my life. How easy is it to turn on the shower and hop in? And when was the last time any of us had to crawl about the floor just to keep it clean? I suppose this could provoke the natural response that we take many things for granted, but that’s not what I’m going for. I would say that we (or at the very least, I) let the conveniences of my life keep me from enjoying the inconveniences that come up. There’s got to be a moral in here somewhere, so here it is. Do something the hard way. Forget that there’s probably an iPhone app for whatever you need to do and go out there and get your hands dirty. It could be more fun than you think.

Next up: Why am I here? (Not on this planet, but at my desk typing this blog.) 

Welcome!

Hi Everyone,

If you've landed here than you must have at least a somewhat passing interest in my whereabouts. This is my first post and I'm excited to be writing it. I think the is somewhat overdue, but it's better to start late than to never start at all. I intend to write this the same way that I speak, and that comes with a warning. If you've never had a conversation with me that you enjoyed, then you should probably turn back now.


For those of you who don't know, I'm spending my summer in Ghana working on a project with the Institute for International Programs (IIP) at Johns Hopkins. I have no idea exactly how much about my experience people would like to hear, so I'm just going to share what comes to my mind. If you have any specific questions or interests that you'd like me to address, let me know. For now, let's begin with a brief introduction to what I'm doing here. In fact, what I'm doing here might be jumping into the deep end before learning how to swim. First, let's look at what the overall program is doing. (It'll be more interesting anyway, I can guarantee.)


One of the key indicators for the health status of a country is the under-five mortality rate, which is measured by the number of deaths among children under the age of five per 1,000 live births. While it's called a "rate," it's more often explained as the probability of a child dying before his or her fifth birthday. Not such an uplifting idea. Under-five mortality is generally measured every 3-5 years through national household surveys, the most well known of which are the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). 


The problem with measuring under-five mortality at such large intervals is that it becomes hard to use this indicator to evaluate the performance of a health program. Imagine a program targeting improvements in child health that runs from 2002-2003 but the only available on under-five mortality come from surveys for 2000 and 2005. Many changes could have occurred either before or after the program was implemented, making it particularly difficult to attribute any change in under-five mortality over the 2000-2005 period to this specific program. That's where IIP comes in.


Our program is exploring innovative methods in collecting data on under-five mortality, with the specific goal of producing accurate estimates with greater frequency than is currently the case. Ghana is just one of several countries participating in this program, which is called Real-Time Results Tracking (RRT). In Ghana, we are using community-based volunteers (CBVs) to collect information on vital events (births and deaths) within their communities on a monthly basis. They use a standard template that we have designed and submit these forms to district supervisors at the end of each month. Our goal is to explore how the under-five mortality rates from this method compare with those produced by the gold standard methods currently in use (i.e. household surveys). To most precisely gauge this, we are also conducting a complete household survey at baseline and endline for all communities involved in the project. So that's probably more than you wanted to know about what's going on here. There are interesting things to say about my role in things here, but I'll save those for another post.


To those of you making it this far, thanks for reading. I've included a few photos taken around the office and surrounding area. The first is of the Nuguchi Memorial Institute for Medical Research sign in front of the main building. (Is this really called a sign? I'm sure there's a better word but it's escaping me right now.) The second is a view of the Prince Al-Waleed Clinical Reserach Center, where my office is located. The final picture is of the courtyard of the same building. It's the rainy season here, which helps explain why everything is so green.


Alright, that's all for now. Take care and see you guys soon.