Journal #8: "treatment"

As I think about my question lately I have been focusing on the word "treatment". At first it just meant the physical treatment that was administered to patients but upon discussing on Friday, the words came out of my mouth before I even realized it and I thought about the word on a different level. The treatments administered to patients are physical as well as emotional. The way doctors treat an individual according to their sex is the construct i am looking at and the whole time I have been developing this project for my senior thesis I have been thinking about the dire situation that so many people in this world experience. The lack of proper healthcare is more rampant than we know. Even in the United States. Politicians all claim to have the answers to this worldwide issue but when is the problem really going to be fixed? It seems like this extends to an even larger sphere in my mind because it is not only about people being able to get physical healthcare (i.e procedures, antibiotics, etc...) but it is about people being "treated" in both senses of the word as human beings, as equals among everyone. In my experience growing up, I have been taught to treat everyone with respect and love but I did not think about how differently I treat boys vs. girls, or even male professors vs. female professors. I don't know what the extent of my personal treatment toward different genders is but I know that it is there. I am going to make it a goal this week to pay attention to how I treat males vs. females in different situations to try to get a feel for this concept. Treatment in both ways, physical and emotional will affect this study so understanding my own concept of it is important.

Journal #7: Developing Questions

With each new day comes a new question asked, a new concept learned, a new fear to conquer. As I search for articles and sources each day to validate my ideas and thoughts, I come to conclude different things though each time it just takes my excitement and curiosity to another level. Today's topic of interest came about when I was thinking about my question and how I developed it and I started to ponder on the process that got me to where I am now with my research question. After declaring my major at the end of Freshman year I felt exhilarated and ready to start my life at that moment. I was not sure where anthropology was going to take me nor did I understand what field work was, nor did I even think that I would be going to Africa in a few short years. The first time I really gained an interest in my topic was when I was talking to one of my professors, Sheila Bibb about her research. I started to research Medical Anthropology and what it encompassed. I have never been one to want to be a nurse or doctor but I have always had this desire to understand the human body and what causes certain ailments (physically or emotionally) but at the same time I am fascinated with the socialization of human beings within society and why we do the things we do. My particular interest was sparked in Africa one day and I have never looked back. I began by just googling "healing in Africa" and "traditional medicine" and "witch doctors in Ghana" and such. With those hours of searching the web my ideas and thoughts evolved and I started to read books and articles about gender and medicine and the effects they have when combined. Somehow all these ideas converged with an interest in malaria, probably because of the relevancy of it in Ghana but out of many many steps along the way emerged an idea. That idea had guided my thoughts and actions for the last year or so and everyday I am trying to learn more. I wish that I could focus on this and only this (because I sure would like to skip out on statistics) but at the same time I am grateful for the limited time I do get to spend preparing these days because I cherish the learning and hold onto the insight I gain. In our last class we did an activity which workshopped our project questions and tried to refine and better them. I started really thinking about the scope of my project and what exactly it is that I want to know. There are plenty of things that I want to find out and be introduced to, but what things do I want to really come to KNOW within the data I analyze and the experiences I have? I can't answer that question quite yet but I have identified a difference in my mind and I plan to explore it to make my question as effective and telling as I can.

Journal #6: History of healthcare in Ghana

                                                    
 A nation which has forgotten the quality of COURAGE, which in the past has been brought to public life is not as likely to insist upon or regard that quality in its chosen leaders today - and in fact we have forgotten. -JFK 

           I am not one to be huge on politics but I do believe that he speaks the truth... I feel like leaders today have lost sight of who founded this nation and what we stood for. Of course the founding fathers were not perfect and every human has their faults but it seems that we have lost a sense of courage in our politics. Our government is a huge part of who we are as a nation and has greatly affected the way our country functions and why we are the way we are. We talked more extensively about the history of Ghana today in class and how its government and politics have affected the country. Being a white American, growing up in the middle class suburbs, I have lived a life that seems to be 100% different from that of most Ghanaians. While I know that is not completely true, I do know that there are things I will need to understand and be aware of if I am to try to understand this culture and this people. The country they grew up in and call home is so different from mine. Upon discussing these things in class, I really started to ponder on how extensively each country is defined by their past and by the things which they have seen in their lives. Be it because of the government they have lived under (or lack of), or through the events that have greatly shaped the identity of their nation. Reflecting back, I realize how immense this impact has been on my own life and how much the history of my country has influenced who I am and what I believe in. My project will give me a particular understanding of healthcare and how it has been influenced by Ghanaian history. Thus, I did some research about the history of Ghana's healthcare systems since that will likely influence my project on a large scale:

      As is highlighted in the 2010 Half Yearly Report by Ghana Health Service, one of the main healthcare providers, a large concern within the healthcare system is gender. They want the assurance of equity in healthcare programs and Dr. Linda Vanatoo laid it out plainly when she said, "In all our activities in the region, gender issues were critically taken into consideration. During the year under review, staffs from the regional training unit of the regional health directorate undertook some training in gender mainstreaming. It is hoped that orientation would be given to key staff in the period ahead so that gender issues would be inculcated into health service planning and provision in the municipal." (pg.23) [i] Gender issues will no doubt be seen among doctor-patient interactions and thus i will be discovering the extent of it's influence among Ghanaian people further. I have chosen to do this through the lens of malaria. One reason being that malaria and HIV/AIDS both have a significant impact on the Ghanaian population thus, I have chosen to combine these two elements (gender and malaria) in the scope of my project. A large reason why I want to focus narrowly on those patients who have malaria is because of the large number of people who are infected or who have been infected with the disease...malaria is a huge threat to the population so researching within its scope can benefit medical discourse.

      Healthcare in Ghana is provided by the government and is mainly administered by the Ministry of Health and Ghana Health Services. Within those there are 5 levels: health posts (first level primary care for rural areas), health centers and clinics, district hospitals, and last, regional hospitals and tertiary hospitals. 35% of the hospitals are run by religious groups and healthcare is varied throughout the country. Rural areas are often left without modern healthcare so these patients rely mostly on traditional African medicine or must travel long distances to obtain care. Historically, village priests (fetish priests--name for witch doctors in Ghana) were the primary care givers. Herbal remedies and spiritual healing encompassed the extent of treatment. Western medicine was introduced to Cape Coast by Christian missionaries in the 19th century and it wasn't until after World War II that outside organizations like WHO (World Health Organization) and the United Nations Children's Fund jumped into provide additional care. Unlike the yesteryears, Ghana has established the National Health Insurance Scheme which was put into place when John Kufour, former President, wanted to get rid of the cash and carry system where money would have to be paid at each step of treatment. This system came into play in 1992 with the return of democratic rule to the country but wasn't passed into law until 2003. The Ghanaian healthcare system is constantly improving and has much potential and success as it continues to (hopefully) meet the specific needs of its citizens. 
     Because of the scope of the Ghanaian healthcare system and the history of the country that has influenced it, I anticipate that I will be seeing effects of their culture and background in the clinics and hospitals, even among the witch doctors that I come into contact with. Governmental policies and instruments will play a large role in the functionality of these places and the attitude that is found within the walls. I have not had much experience with the American medical system because I have lived a relatively healthy life but I have experienced urgent care and quick doctors visits and such so it will be interesting to reflect back on my own visits upon observing the experiences people have within the Ghanaian healthcare system. Since my project focuses on the doctor-patient relationship and how the patients gender affects the way doctors administer treatment to those who have malaria, it will be important that I understand the cultural context and historical background that is a basis for why things are the way they are within that which I observe. 

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[i] Vanotoo, Dr Linda. "Half Year Review Report: Ghana Health Service." Your Health,OurConcern.Web.4Oct.2011..

Journal #5: "Time is going to take my mind...and carry it far away where I can fly"

What is the essence of time? All that I have done so far has brought me to this place, right now. I have lived in a world revolving around time for my whole life but it wasn't until today that I actually thought about the significance of it. Today we were assigned to read an article for class about time. It discussed how different time can be to other cultures. In the past paced world we live in here in the United States it feels like we are bound by time. There is always a schedule, always an appointment, always a commitment to uphold... but it is not like that everywhere around the world. In a discussion we had in class we talked about how sense of time is different in Ghana and that is certainly some thing to get used to. If I set an appointment to meet with someone for an interview in 2 hours they might not come for 4. Simply because their daughter came home and wanted to discuss something with them and family is far more important than keeping an appointment with you. I realize that time is relative to the beholder and the culture one is encompassed in. That is one more adjustment I get to look forward to. I am not sure how time works in the hospitals and clinics though? Something to explore. Do doctors appointments and visits go according to a scheduled visit time? Are there scheduled visits or does one simply show up and wait for an available doctor? What is time going to be like in everyday activities? All things I cannot wait to learn about and adapt to as I embark on this journey and experience my RIGHT NOW.

Journal #4: The Golden Stool

For class on Wednesday we talked a little bit about the history of Ghana and its politics and such. One of the most significant markers of unity and strength for Ghana is the Golden Stool. The history of the stool is as follows: The Ashanti Kingdom in Ghana West Africa, was founded in the seventeenth century by King Osei Tutu I, with the help of his feared Priest Okomfo Anokye. The myth is told that Okomfo Anokye conjured the famous Golden Stool from the sky and landed it on the lap of King Osei Tutu, the first King of the Ashantis. The Fetish Priest declared that the soul of the nation resided in the stool and the people must preserve and respect it. Ashantis believe that just as a man could not live when his soul is taken, so the Asante people would disappear from history if ever the Golden stool were taken away from them. Covered with pure gold, the Golden Stool is never allowed to touch the ground. When a new Ashanti King is installed, he is merely lowered and passed over the stools three times without touching it. Whenever the golden stool is taken out on special occasions, the Asantehene follows it. Throughout history, wars have broken out over this object. It symbolizes the power and soul of Ghana. It is a huge part of their identity. Many things depict this object and symbol. Stores are named after it and pictures and symbols are apparently all over this country because of what it represents.
      From learning about this simple piece of history, I have decided to really try to learn about and recognize the simple things that influence a persons culture and by extension, their identity. There are going to be things that come up in conversation between doctors , traditional healers, and patients that have stemmed from their sense of person-hood that has been attained from their connections to Ghana as a place, and as a part of who they are. It will be critical for me to be able to identify and understand these things if I am to analyze these interactions to the very best of my abilities as an anthropologist and I am excited to keep learning more about it everyday.

Where do I go from here?

I feel like David Bowie said it best... so I won't expand on that but I will say that this is how I feel almost everyday. When I wake up each morning I think about what is in store for me that day. These days, it consists of school, work, school, work, gym, school, and the occasional activity at night. For my whole college career I have felt like I had a destination, a purpose for the hours of study, and that has all led up to what I feel will be the climax of my education, Ghana. Oddly enough, now that my goal is so close that I feel like I can touch it...there are times when I feel a bit like I am moving without direction. I know that is just fear and insecurity creeping in so I try to focus my energy on what I am doing and where I am going and I sure can say that it will not be (and certainly is not) boring. Not for one minute.

Journal #3: Learning Twi

     English is the national language in Ghana so thankfully I will be able to manage quite well with my native tongue but with the nature of my project, I want to learn Twi as well as I can before going to Ghana. I don't know how much Twi will be spoken in comparison to English in my observations of healer-patient interactions and I do not want to be blindsided when I am in Ghana where I can't understand a thing that is going on around me if Twi is being spoken by both individuals. Of course I cannot learn the language sufficient enough to understand everything nor to even be able to speak a full sentence back but I sure am going to try to learn every single thing that my brain will take in. Not only is it very hard for me to essentially teach myself a new language (or anything for that matter) but having the power in my brain to recognize sounds and letter sequences that mean something in another language is going to be a real struggle. I can say a few simple things already but if I do not think about or say it every day then I have lost progress by the next. I pray every night for the gift of tongues whilst learning this language and especially while I am in Ghana because I sure am going to need it.
      The reason why I feel like it will be so important to me is not only because I want to immerse myself as fully as I can into their culture (communication being an essential part of understanding...not just with language), but also because within my project methods I will be sitting in on healer-patient interactions and I do not know if those who are being healed and those who are healing will be speaking Twi or English, maybe even Twiglish but the point is, I do not want to be stuck with something I cannot analyze, nonetheless understand from an interaction with a traditional healer and an older Ghanaian man who are speaking Twi. As i am writing this, I am taking a break from studying my alphabet and simple things like 'we', 'you', 'I', 'us', 'they', etc... every time I think I get it, I try to translate a sentence from Twi to English or vice versa and the singular/plural stuff messes me up. Anyone speaking French, Spanish, Italian, or whatever else should be eternally grateful to Google Translate for the services they provide. I sure would love that help right about now. Regardless of the struggles and frustrations I get so excited every time I open my "Lets Learn Twi" book because everything about this experiences makes my heart soar!

Project Question

So far, the research question I have developed for my project is: 
        Does gender affect the way healthcare is administered by traditional healers and biomedical doctors when a patient is infected with malaria in Wiamoase (or Asamang), Ghana?
 All the development I have done thus far has been on this question though as I do more research throughout this semester, there may be some tweaking done here and there. I don't love the way it is worded yet and as I do more research and dive even deeper into the literature, I hope to get it just right. 

Journal #2: finding myself through anthropology

Many times when people ask me why I am an anthropologist, and why I chose anthropology as a major because 'what are you going to do with that?'... i do not entirely know how to answer them. I usually just say something like "because I love it" and leave it at that. Lately, I have been thinking a lot about my path in life and the effect this education is having on who I am. With all this thought I have concluded why I love anthropology so much and why this Field Study is going to change my life. Anthropology is the study of human beings (contrary to what some people may think, I am NOT getting an education to manage the store Anthropologie). With that study of human beings comes theory, data, methods... an attempt to understand the motives behind why they act the way they do and how that influences them as a person and extends to their community, their society, and thus...envelops the culture through which they live their lives. Culture for me is more than just what influences their daily activities and character. It is the way one breaths. It is the way they eat, dance, think, dress, love, feel, speak, play, sing... it is the way a person defines who they are.
          One of the reasons that I am so excited about my project is because I will have the opportunity to interact with human beings who have grown up in a completely different culture than my own. People who have had entirely different experiences because of where they live on this earth. But what makes me so excited is thinking about how despite all our differences, we will still be so similar. So far, my project description is this:
Project Description
The ultimate goal of this project is to see if gender affects the way healthcare is administered by traditional healers and biomedical doctors when a patient is infected with malaria in Wiamoase, Ghana. Since the healthcare situation around the world is one which is ever changing as new developments surface and new conclusions are made, new research is needed to keep up with the rapidly evolving field. Thus, my research will contribute to the larger theoretical effort of medical anthropology and socio-cultural anthropology. Malaria is a disease, rather an epidemic which is prominent in many countries today, including Ghana. I will not be researching the disease itself but rather the way gender affects doctor-patient interactions when one is infected with the disease. Since there are many different factors which could influence the way a traditional healer or biomedical doctor treats a patient, I have chosen to hone in on gender so that results will be more easily isolated. In order to carry out this study and attain useful results, I will employ several methods to collect my data. Primarily, I will be video-recording interactions between doctors and patients as I will be seeking to discover whether gendered differences can be identified through observation of interaction between patient and healer. I will also shadow select traditional healers and doctors at the Salvation Army Clinic and observe the way they diagnose malaria and administer treatment. This will help me to better understand the experiences patients are having and see from the healthcare administrator’s point of view how/if gender plays a role in their practices. Furthermore, my research can impact the gendered healthcare discourses in the medical field right now and give doctors as well as patients a better understanding of the outcome of gender differences. By utilizing these methods I hope to gain knowledge and statistical analysis which will help me add to the larger theoretical perspective.
With this study, I hope to not only learn and apply theory and methods and data to add to the general anthropological discourse and more specifically, the medical discourse...but I hope to learn about these people for myself. I hope to come to understand their culture and in doing so, understand IF that affects gender differences among healthcare administration behaviors. Throughout this experience I expect I will indirectly learn more about myself in understanding more about other human beings who live across the world. I am so excited to become immersed in their culture. To learn to think and act as they do in order to ultimately understand more about God's children. In the end, that is my main goal.

Landslide

"Well I've been 'fraid of changing cause I've, built my life around you" -Stevie Nicks Just as the seasons change, so do our lives. My best friend growing up,Taylor Layla Cain got married over winter break. Not only that but Maddie is about to go to Latvia to serve a mission and Erica just got her call to Moscow, Russia. These three girls hold special places in my heart and they have each helped to shape me into the person I am today. As they all embark on their adventures this year, I will embark on one of my own. They, along with my family of course, have always been by my side to run to, to cry to, to laugh with, and to learn with. Now we are parting ways and going to fulfill our individual dreams. I have had a hard time learning how to deal with this fact but I am ready to face it and grow from these experiences. I no longer have this crutch to lean on and to depend on when I feel like I am ready to fall because thats what they have been for me but now as I learn to stand alone I will learn to rely on the Lord even more and becoming even closer to Him is something I really look forward to.

Journal #1: Its just the Beginning

 As the field study prep course commences it is time to really dig in and embark on this journey. I have been having an emotional few weeks because of the many changes coming about right now. My best friends are all going through so many changes including marriage and mission calls and I didn't realize how much it would affect me but now that those things are upon us, I am really feeling my life switching from a comfortable place to some place that I am not quite sure how to handle. Nonetheless, I feel like I have been preparing for this for my whole life. I am excited for this semester because the preparation for Ghana itself is going to get more intense and is going to teach me things I didn't know about myself, Ghana, and others. We read an article for class on Monday titled "What Students Don't Learn Abroad". Listening to those comments from facilitators who have already been to the field were very different than those comments from people who have not been abroad but the general theme for me was simply, understanding. Understanding that while I want to share my culture with the people in Africa, I am there to learn about them. I am there to gain an understanding for why they do things the way they do. For why they speak, and dance, and heal they way they do. For why they believe what they do and much more. While I have lived a very privileged life here in the good ol' U S of A, the people I will interact with and come to know quite personally have experienced a whole different world and I want to know that world. In order to do that I need to leave my preconceived notions and my American-ness in California when I say goodbye to my family and step onto that plane. Of course, I am an American and have only known the culture in the United States and even more, in the LDS community for my whole life but I am ready to experience something new. I am ready to become one with the Ghanaian people in learning their language and how they experience life. This is just the beginning of my quest to understand the world. That is cliche I know, but I truly do want to know more about God's children and what better way than to study among them. As an anthropologist, I am always studying people's behaviors, even among my best friends and roommates. I analyze their actions and words more than I ever have before. Even upon just meeting someone I want to know about their background and life experiences and what led them to being the way they are. It is fascinating to me. Human beings are fascinating creatures.This prep course is basically the same as my Ethnographic Skills class for anthropology. The good thing about that is that I have my project proposal well developed and got an A in my department for it so as far as the requirements go for anthropology I'm solid (there will be tweaking here and there of course). With that proposal being complete, I have the opportunity to use this course as a refiner and a tool to creating the best possible project so I can really do my best research and really come to love and understand the people I interact with.