The eyes have it but who cares?
I have always had problems with my eyes and, in the course of a fairly physical as well as intellectual life I have suffered just about every operation on them known to ophthalmologists. If eyes are the windows to the soul, then whatever spiritual essence resides inside must be mutated out of all recognition!
Anyway, my retina managed to throw up another problem three thousand miles from my regular consultant in the UK. A good friend arranged a private appointment with an ocular expert in Accra (actually, nearly all Ghanaian medical treatment is private). I arrived at the clinic in good time, registered and paid for the consultation. Then I sat and waited for the doctor to arrive. His list was full and the waiting room crowded. Nearly an hour passed and then he phoned to say he was stuck in traffic. This is normal for Accra but, if I had been the doctor I would have taken account of it, wouldn’t you? I decided to abort the appointment, feeling demeaned and angry. I wondered whether a doctor who shows that much respect for his patients would be any good, anyway? The more a professional feels accountable to customer, client or patient the more he or she ratchets up the quality of his or her work. For a number of years I worked across the medical firmament in England, developing appraisal measures which might improve not only the quality of expertise among doctors but also their attitudes to patients, nurses, managers and juniors, their time keeping, their team work and their self-critical faculties. It was a rocky ride because there was so much professional arrogance abroad at the beginning. But it helped to change the culture.
Many if not most of the consultants here in Ghana train in the UK or US. If in the former then they would have had to abide by the appraisal system to which my team and I contributed. Then they return to Ghana and a proportion of them are too delighted to embrace arrogance and dump any notion of accountability. They have re-joined the Ghanaian middle class. When I asked the receptionist whether the doctor was usually late, she smiled benignly and said, “He is a doctor”.
In Ghana, accountability hardly exists in practice though the rhetoric is very western in language and structure. If someone sells you a bum service there is little redress. Socio-political reforms show hardly any palpable result. The general populace is utterly cynical about government bodies, professional services, corruption and backhanders. It is sad because ordinary people in their towns and villages are remarkable in their general capacity to get by. Change will only occur here when the middle classes forget about feathering their nests and maintaining their vantage point in the class system and begin to institute hard-edged offensives against corruption and grossly unprofessional conduct.
Labels: Ghana. Medicine. Professionalism. Patient care.
Skin deeper
I am writing this on the road back from Cape Coast to Accra. We have just spent the weekend on the beach; long stretches of sand and coconut palms, a few local villagers walking to and from Elmina, a small and delightful fishing port. From the chalet they are silhouettes, carrying large basins full of yams or firewood through the palms with the sea breaking behind them. We ate fresh grilled lobster and squid, grouper and snapper under straw lidded canopies, walked the isolated sands and rested. This morning we drove to Elmina on the way home to buy fish. It is an enjoyable half hour if you like haggling and checking the species covered in ice in big pails. All the while the sellers assume you will pay four or five times the price a black skin can afford. Even with the help of a six foot female who calls herself the Queen of Togo, the bartering is in favour of the locals. Not that I mind. The redistribution of wealth is built in to skin colour. If I can buy fish at half shop price and they can sell it to me at twice local price, then who can complain? We are a bit late at the market so there is no squid or octopus and few of the more exotic shapes and colours but we buy two plump and richly red snappers, some silver fish which are flat ribbons, moss green grouper, barracuda and a bag of whitebait. I like it at the market, the bustle and noise, the shouting of wares and the smell of a fresh catch. It is redolent of childhood forays with my father to North Shields from Newcastle on the electric train, to fish off the quay at seven in the morning, catching crabs and coley and the occasional cod. It’s strange how smells which might turn the nose of someone new to them become familiar, embracing and latterly nostalgic.
As I write we are half way to Accra and have just passed a couple of young men trying to sell grasscutters. I must look them up. One of my first Ghana blogs included a description of grasscutter stew. The grasscutter appears to be a large rodent, a bit like a coypu but they are sold by the wayside in smoked form. Imagine quite large bellows, flattened or spatchcocked, except the bones are visible like x-rays against the deep brown of the charcoaling and on being held in front of the vendor this gourmet’s delight obscures half of his body.
The skin colour based interchanges mentioned above work rather badly for mixed race individuals Someone with a fair skin (for Ghana this means, say, Lebanese brown) may be the subject of racist abuse in Europe and then find himself or herself similarly dealt with over here, in reverse. A victim in both worlds. In general I have found Ghanaians remarkable in their ability to laugh at the racism they have experienced abroad, though I would have exploded with outrage, I am sure. I interviewed a woman the other day who had been a supply teacher in the UK only a few years back. She had arrived at one primary school and the receptionist told her to pick up an apron and join the canteen staff in the kitchens. When she revealed her identity, the woman was embarrassed and said that because her name was so English sounding (traditional English names are common in coastal Ghana from the slave trade and gold mining) she had expected a white woman for the teaching job.
Managing staff can be difficult too. Skin can get in the way. Ghanaian culture, for example, has little evidence of what we might term depersonalised critical dialogue. To manage anywhere in the world you need to establish the criteria upon which you judge a person’s performance. But to tell someone that their performance is under par even when citing previously agreed and understood criteria can be taken very badly and the race card can appear. We carry our skins like badges as we traverse the world. A lot of the time and energy is spent in finding ways to disclaim responsibility for this birth-packaging.
Labels: Racism. Skin. Ghana culture.
Covering the Japanese Tsunami, UK style
I suppose that the more you travel, the less jingoistic you become. I am three thousand miles from the UK these days and it seems like so many light years from home - not! That’s it, really. Home is for me an ephemeral outdated concept, maybe the place of my childhood or childrearing years but many like me are now wandering creatures, itinerants in search of answers to questions we have had little time to frame because of our very movement, the constant change that has become our way of life. We may, like the Buddha, seek through our journeys to find enlightenment, somehow knowing it is not likely to be found in the fixed geography of our history but what we discover are peoples in lands who are just like us, clueless as to what existence is all about.
The expatriated gypsy flunks the test of knowledge more often than not by assuming that coming to terms with a new location, a foreign culture is somehow the same as discovering deeper answers. While engrossing and diverting, it rarely is. We carry our history on our backs. We live and die in new scenery, that is all.
Meanwhile, those we have left behind and who populate the ‘old country’ seem to become moored and mired in their unchanging homeland. Everything is weighed and measured against its history, its traditions and its certainties. Even when these stay-at-homes cross borders, they have one eye over their shoulders to make sure they can get back to safety as soon as the little adventure is over.
I am digressing in this ill-formed way as a lead-in to something which seems obvious to me but may not be to those whose news service it is. Watching the UK’s Sky News coverage of the tragedy of Japan’s earthquake and Tsunami, I felt somewhat ill at ease by its approach. It had a team out on Japan’s east coast. They made it seem that they were braving danger. They were concerned about the British who might be caught up in it. They talked to Save the Children workers about what they might do to alleviate the horrors for Japanese children. They rolled out the Minister who proudly boasted of the sixty odd crack force on a search and find brief. They marvelled at the Japanese refusal to loot, their order and discipline, they produced little cameos of individuals searching flattened towns for their loved ones. Worse, they played over and over the engulfing black sea of destruction as it took everything in its path, played it with their own version of the sinister Jaws theme, deep reverberations and oriental cymbals in disharmony. They played up the fears of radiation and how far it might be spread by winds.
In other words, it was news for those who can never shake off the notion of home. It was a cake of horror and it was to be eaten by those who are safe and far away from it all.
Al Jazeera, on the other hand, gave it straight, without translation into a UK cultural context.
Labels: Japan. Tsunami. Sky News.
It's life but not as we know it, Captain...
Leaving aside belief in gods, the hereafter, heaven and hell and the trappings of metaphysics, where are we when we drop, for example, the meta in the last domain? Where are we with science, generally? Do we believe it? The professions are certainly beholden to it. Law now has its forensics, medicine has its pharmaceuticals, the food industry has its nutritional values, the home has a complex reliance upon science in all its forms, from entertainment through heating, cleaning, birth control, depression and on to an induced good night’s sleep. Gradually, the science is outstripping our capacity to understand how it works. But hasn’t it always been so?
The arrival of margarine heralded a new healthy alternative to butter. It was decades before it was realised that trans fats in margarine were potentially lethal. Obesity is rising rapidly in all countries that adopt western fast and processed food regimes though the manufacturers stay on the legal side of the scientific protocols for what constitutes harm. Salt and sugar are being reduced but only after a few million heart attacks, diabetes and early deaths. Powdered milk is being sold to mothers in subsistence cultures as they are being weaned off breast feeding. Skin bleaches are sold openly across black nations with some terrible consequences. Cosmetic surgery is a growing trend for the emerging middle classes.
Thalidomide was sold as a safe drug until misshapen babies arrived. We were captivated by menthol cigarettes as a healthy alternative to straight tobacco; “cool as a mountain spring’ was a strap line. All the while, in ads, we see serious looking white coated professionals, still with clipboards, researching the efficacy of products. We buy the hype and then curse ourselves when the bad news filters out and it is too late. We assume, I suppose, that the tests are all finished with, that the beagles and rats and volunteer humans have given their bodies to make us safe.
That is why the Sky News expose of the maltreatment of Gressingham ducks in Hingham Norfolk, with brutal keepers holding birds by the neck to beat the others into the hangars, while dead birds lay untouched on the ground to rot, was so offensive. Trust was broken. These had been sold by Waitrose Supermarkets as having been regularly inspected by their scientific vets. They were sold as organic birds and were at the top end of their sales meat chain.
It was visual agitprop for how we have become disenfranchised in understanding the science of our own lives.
Labels: Gressingham ducks. Science. Scientific ignorance
