Journal #12

This week is the first week I feel like things are finally going my way! My passport problems got situated, I scheduled my vaccinations, posting journals has become much easier, and I’m reading really interesting articles influencing my project. So I guess you can say it has been a pretty good week (knock on wood). I am really starting to feel like everything is finally making sense. On Monday we talked about ethics and I although I’ve briefly thought about them I’ve never really sat down and written out exactly what ethical issues I’ll run into. I guess that’s why doing these journals is so constructive.

1.     My research involves children.

Right off the bat this could throw up tons of red flags. I cannot directly involve children into my research but I need to go in a round about way and involve their caregivers.

2.     My research involves women.

I’m not entirely sure on the position women have in the house hold but in certain countries I know the women is beneath the man and is only allowed to do what he says. I could run into those who do not want their wife being involved in a research project.

3.     I am asking about personal beliefs on what medical care they choose.

I could come off as being judgmental in a way if I don’t watch my reactions. I don’t want anyone thinking that I prefer a different method opposed to theirs because they could either clam up or fight with me. I don’t want either to happen obviously so with further methodology practice that will get easier.

4.     I am involving the health care industry.

There can be very personal issues within the health industry. That is why doctor-patient confidentiality is so necessary. I realize there are some things that people do not wish to talk about to a total stranger like myself. By building up relationships with people I think this issue can be broken down little by little.

I know there are so many more ethical issues that I haven’t even begun to go into but with the help of this prep class I think we’ll be able to dive further into each of them. But for now, wish me luck on the 500 shots I have to get today!

Annotated Source- Mother's Education and Childhood Mortality 2

I was really interested in the last annotated source I did and wanted to do another post on it. I'm thinking I might want to incorporate mother's education into my research and go down that path. We'll see what happens.

This research had three different markers of child's health: infant mortality, child's height-for-age, and immunization status. The studies does show that although it is not a direct correlation, there is a strong positive correlation. Education is a good measure on the families socio-economic standing. The income affects where the family lives and that affects availability to clean water and clean water affects child's health. You get where I'm going with this.

So why does education matter in child's survival? Education has two major reasons. People with an education use health services more and result in a wide range of beneficial behaviors. Women who are educated pass along their knowledge to their posterity and brings about better individual behavior. This is all around us here in America. I am from Texas and we have an enormous amount of immigrants in Houston. The lady we use to clean our house is an immigrant herself. She never went to college and I don't even think she was able to graduate High School. When I got accepted into BYU she was absolutely thrilled for me and told me not to waste my time and to study all the time and never get a boyfriend and stay focused. :) She really wanted me to succeed and not be stuck without knowledge to get a high paying job. Marina, our house cleaner, has two children, Yolanda and Caesar. Yolanda is 18 and going to college in the Fall. Her mother worked as hard as she could so that Yolanda could go to school, graduate and move onto College. She knows the benefit of a college education and knows the benefits her children will receive. Marina is such an inspiration to me and her hard work to make sure that her kids receive a quality education and keep up with all of their school work.

The article goes further into the other countries that were used in the research and found it to be true in every region that the mother's education affected the children's survival.



The article can be read here.

Journal #11

This weekend was much needed. I have been so busy with writing papers and studying for tests this week that I didn't really get any sleep so last night I came home early and crashed. I value my sleep and am so happy when I get to catch up on it. 

My mom, bless her heart, is extremely nervous for me to go to Africa, so to calm her nerves a bit, she emailed one of her family friends who has been to Ghana 7 or 8 times. He is a doctor so most of what he mentioned was health and safety related but still very helpful. He told me which anti-malarial pills (EXPENSIVE!) and what I should drink and eat over there. 

For today's Journal post I thought it would be really interesting to look at the entertainment side of Ghana. I realized that I am good at building rapport here in the United States because I am educated on what is going on around me. I know most celebrities, lots of different bands, and have seen a lot of movies. I am not a pop-culture fanatic or expert but I am aware of it. So that got me thinking… I should do some research on Ghana's pop culture. I thought I would mainly dip into the music aspect. To me music is everything. Music brings people closer together and can change your mood in an instant. I am a fan of most every genre but my favorite is very mellow acoustic music. As I was researching Ghana music I found that rap music was the most popular. I don't know if that is the case in Ghana or if that's just what people look up on Google but I actually like some of it. Although, they don't call it rap, they call it either "high-life" music or "hip-life". Sarkodie is one of the most popular Ghanaian rapper that wins a lot of awards at the African MTV awards. I love it when he raps in Twi because he speaks it's SO fast! His music isn't the most appropriate so I won't put it up on the Blog but other songs like Black Star by Sway are really catchy and pretty cool. I have already learned a lot about Ghana from just listening to their songs. 

However, they do have a lot of traditional music too. It really all depends on the region of Ghana you go to. 

What I have learned about Ghana through their music

1. Ghanaians are PROUD of Ghana. 

2. They are very celebratory people, they love to dance.

3. They like Soccer, A LOT.

4. Ghana is a very diverse country. No one part is alike

5. I'm already in LOVE with the people over there.

Annotated Source- Mother's Education and Childhood Mortality

This article is absolutely fascinating. It evaluates the mother's knowledge and the affect it has on a child's health. These two factors have never been compared before in Ghana. The conclusion is that mother's education inversely affects child survival. About 40% of women with no formal education immunized their children whereas more than 85% of women with secondary education or higher immunized their children. The educated and higher socio-economic women used facilities more than the uneducated and lower socio-economic classes. Education affects income, and income is one of the greatest obstacles in healthcare.

The author did research on a topic very closely related to mine. It seems obvious to me that increased maternal education would decrease childhood morbidity. In Ghana most women do not receive a formal education and a large percentage of them are illiterate. These barriers decrease their access to health care information and resources. Because of the lack of health care information in certain parts the tendency to utilize traditional medicine and self medications and that leads to increased childhood mortality.

I can see that trend even here in America. Families living in poverty don't go to the doctor when needed because of income reasons and without some formal education they aren't sure where to turn to. Education is very powerful and can help out millions of people and their posterity. However, In Africa school sometimes isn't an option. The girl is needed on the family farm to help support them. I believe schooling is free in Africa but it's not usually the cost. The daughter is needed to work and support the family or watch after the younger kids. It is a very sad cycle that will hopefully be broken. Oprah, a very inspirational person, has made efforts to make a school for girls to educate them and give Africa their future leaders. I watched an interview about the graduating class of 2011 and they were all so touched by Oprah's generosity and really saw the effect education had on their lives. The girls were all very inspired to go out and change the rest of Africa. If this continues, hopefully Africa will have more women educated and they can pass on their knowledge to their posterity.

This article is very valuable information to me. I am studying the mother's role in choosing health care for her children but I should maybe be focusing more on what the mother knows about the different health care plans and why she chooses them. As I review different articles my project is always changing and this is definitely an article worth spending a lot of time over.



The article can be read here.

Journal #10

This week has been long to say the least. My classes keep me so busy and I feel overwhelmed all the time. I am taking 15.5 credits which doesn't seem like a lot but 6 classes tend to fill up my day with endless paper writing, test studying, and researching. I don't mean to complain but sometimes life just really gets you stressed out. I have had a couple phone calls to mama this week which have helped me to just vent. I love the prep class but I feel like there is an endless amount of stuff to do for it. Six blog posts, methodology reports, contract reports… I don't know it now, but all this work will pay off once I'm in the field.
In Friday's class we talked a lot about the language identification and used the example of the car. We discussed how there would be a definite language between a car expert and someone like myself that knows absolutely nothing about cars. My uncle owns somewhere around 22 cars (most vintage) and is obviously very passionate about cars. He doesn't talk much but I did try to get him talking about his cars and he sure did talk my ear off. However, I understood about 10% of the conversation so I found myself tuning him out and focusing on other things in the room. I'm a horrible niece I know but I really couldn't understand half of the things he was saying. But in class it got me to thinking I could definitely do that to someone on accident in Ghana. I am a part of so many "groups" that have their own language. My non LDS friends aren't going to understand what Relief Society is or what the Word of Wisdom is. If I'm not careful in Ghana I could find myself accidentally alienating people with my topics of conversations. I am a white mormon american girl from the south that attends BYU. There alone are so many different groups I'm apart of and could easily find myself reverting back to my usual language. I have to analyze what I'm asking them and defining anything I feel may be confusing. I don't want to create another language barrier when there is already one there to begin with. If I understand their community and values I can better phrase my questions so that I can get the most effective research done. There was a story presented in class about someone who wanted to do their research on insects but the country he was doing research in actually didn't have a word for insect. The word he was using meant more of a pest which included chickens and crickets. Personally because I am researching primarily in the medical field I understand that they don't use the same terms as we do. In America if you say a certain medical issues like arthritis or a stroke, most people will understand you and the topic. In Ghana I have no idea if they call arthritis arthritis or a stroke a stroke. That is something that I can try to find out through research but I feel I am only going to truly know once I am out in the field.

Presentations

I attended the 10-11:30 presentations today and left with so much knowledge. I missed a good portion of Corrine’s presentation on Ethnocentrism in Ghana which totally stunk because that was the one I wanted to go to the most! Oh well, teaches me to wake up on time.  But what I did get from her presentation was fascinating.  She talked about how the Ghanaian government is trying to unite the nation and move towards nationalism.  She discussed that many Ghanaians are for keeping their native and cultural traditions. However, she did mention that it really varies from town to town. She was in a more rural town outside of a major city and inhabitants there do tend to drift more towards ancestral traditions. A question was asked about if Ghanaians believe there is one identity for them and the answer was definitely not.

The next speakers were Jennifer and Kristen. They spoke about the dropout prevention program put in place at a majority Navajo high school on a Reservation Border. The topic was interesting but not even closely related to my area of interest for my research. However, I learned A LOT about the methodology for Field Studies. They began describing the advantages of a participatory evaluation. The students at the school were really “surveyed” out and a participatory evaluation where they were able to have one on one time with the researchers was very beneficial. The disadvantages were posed that it was time consuming. You had to spend a long time building up a relationship with the individual and afterwards you had to transcribe all of your notes. This is what I plan on doing in the field so I learned mainly from their presentation that practicing before hand will really help me. The next major point they discussed was the fact that they were both foreign white girls coming to ask them tons of questions. You could see how some could react negatively to them. Likewise, I am going to be a foreign white girl to the hundreds of Ghanaians I will come across. The Navajo’s and Ghanaians are both similar in that they don’t have very great history with white people. This is something that I can’t help but I believe if I respect the culture and tradition of Ghanaians it will improve our relationship. Focus groups will really help in this sense I believe because there are other people like them and it isn’t as intimidating or nerve-wracking to sit one on one in an interview. I know from personal experience the second someone has an interview with me I get really stiff but in a group setting I’m able to loosen up more.

The third speaker talked primarily about private education in Ecuador and although I didn’t understand everything he was saying, I was intrigued with his topic of interest. Again it was about an educational system and the main parts I took away from his project were the disadvantages or limiting factors he came across. I know that I am not going to come into Ghana with even half of the knowledge I’ll need but anything I research now and learn about now will help me to avoid any stumbling blocks I can foresee. 

Journal- Cultural Differences #9

On Monday we were told where we'll be living and who we'll be living with for the next three months. I have the pleasure to room with Cassie in Wiamoase, and Lauren and Jackie will be living in Asamang. I have my plane ticket, living arrangements, and roommate but it still doesn't feel real! Seriously whenever someone says "I'm jealous you're going to Africa this summer" my first reaction is "Who Me?? Oh yeah that's right I AM going to Africa this summer". I can't even put into words the feelings I have. I am trying to do as much research as possible so I don't look like a complete fool when I get there.  My most recent article I read had to do with etiquette and cultural manners. I want to know their customs so I don't accidentally offend anyone. It fascinates me to think about the differences in 196 countries around the world and the thousands of differences within those countries. My life in Houston Texas is VERY different from my life here in Provo Utah. There is no way that you could ever capture the heart of America because there are literally millions of different types of groups in America. In Texas it is normal to own multiple guns, drive a truck with 4 mpg, and attend every HS football game. Now don't get me wrong, that is not even close to how every Texan is, but is seen to be quite normal. That got me thinking, there is no way that I can read about Wiamoase, Ghana and know for sure what kind of world I will be thrown into. I can have a little bit of a better understanding but it is only through actually experiencing Ghana that I will be have a better concept of it. If I only heard one person's view of how their Ghana experience was and took it for fact, I would be in a world of shock once I arrived. If the person I talked to got sick on day 1 and never recovered their experience would be a little less than desirable. They probably wouldn't recommend ever going again. On the other hand, if I talked to someone who lived in a mansion with running water and luxury amenities my view would be COMPLETELY distorted. I have to take everything with a grain of salt and remember that my experience will be unique and one of a kind. I will even have a completely different experience from the other girls even though we'll be in the same country at the same time. Cassie and I will even be living in the same house, and yet we will all have SO many different experiences. While in Ghana I can't experience a tenth of the differences in cultures there are but I'm ready for whatever Ghana has to throw at me. Spotty electricity, friendly people, noisy/ busy markets, language barriers, mosquito nets, no clean water… BRING IT ON. 

Annotated Source- Culture

The prep class has stressed over and over again the culture shock that we will experience while there. I want to understand as much as I can before I leave. I know that you can't get the real deal from just reading a book so that is why I am so excited to go to Ghana!

1) Etiquette: We have talked about it before and it is very different from what I am used to. You should wait to be told where to sit, food is served from a communal bowl, and shoes might be removed. They wash their hands in a washing bin before the meal begins and you can't eat until the eldest male does so.

2) Greetings: A handshake with a smile is the best approach. Titles are very important. Make sure to use the correct surname and any academic professional titles.

3) Communication: Ghanaians are very forward with their comments. They do not want to cause any confusion in their message whether that's informing someone about a relative that passed away or declining an invitation. However, they make sure to do so in a way that will not harm their relationship with that person. They frequently talk in proverbs to show wisdom.

4) Family: There is a very strong bond of family in Ghana. Families give you your source of identity, loyalty, and responsibility. They share dignity and honor in the family so everyone is expected to uphold themselves at all times. With the Ashanti people, affiliation within the clan is through the women. Mother's have a higher status.

5) People: There are over 100 ethnic groups in Ghana. Their society is based on hierarchy. People are respected because of their age.

As I read this I am so fascinated with the difference in culture all over the world. It's interesting to see how even just from Utah to Texas is such a stark difference and yet we all still live in the same Country. I am slightly nervous but even more excited about the opportunity I have to experience a culture for three whole months. I have noticed through my readings that a lot of the initial meetings are dealing with rapport talk. I am a little too good at small talk, I talk A LOT.  I am so anxious to get out of America and see life through someone else's eyes.

The article can be read here.

Annotated Source

Why do immunizations matter in Ghana? For the last 40 years UNICEF and Red Cross have been providing care for Ghanaians. They now provide 9 disease entities for residents there. Since immunizations have been available in clinics and hospitals most of the diseases have shown a dramatic decrease in the population. Yellow Fever, Polio, and Measles are a few of the major diseases close to being extinct in the Ghana region. In America, we have had these types of immunizations far longer than parts of Africa and we have been blessed with making most of these deadly diseases extinct. A lot of people on the earth today  were not alive during the Polio outbreak or Measles and Mumps outbreaks. But it is so important to still protect ourselves from these diseases. Dr. Kwadwo Odei Antwi-Agyei has been a key factor in getting immunizations to every infant. He is giving the government a big push to requiring diseases to help with the MDG4. immunizations is one of the most cost effective interventions. Shots prevent the spending thousands of dollars needed once the disease has infected the human being.
There is a strong familial correlation and vaccination behaviors. A strong factor in non- immunized children is cost. It is just too expensive to get some of the shots needed.

Article can be found here .

Journal #8

With each journal post I find it hard to say exactly what I want to because I feel like a broken record. I am excited to go to Africa, I am overwhelmed with school, my project still needs focus, and I have no idea what I am doing half the time. My sister, an English major, has a magical way with words and can make anything sound amazing. I on the other hand couldn't write an A+ paper to save my life. So you can see why blogging is so difficult for me. Throughout High School I took English classes where maybe 4-5 papers were due each year and in college I purposely take classes where I don't have to write that many papers. I absolutely fear writing papers. However, I realized that these blog posts don't need to have an intro, thesis, body paragraphs, and conclusion. This blog is my thoughts. This blog is where I show my thought process on going to Ghana. That being said, I have been thinking A LOT about the communication between myself and the Ghanaians. In the past couple of prep classes we've discussed what potential problems might arise and what we can do now to fix those. One of my main concerns was my population. I started off this wanting to do strictly Neonatal care. That is an extremely difficult population to focus on because of the ethical issue. I decided to focus on the under-five years of age population in Wiamoase. I will be using their mother's to interview and have group discussions on the health issues they face with their little ones and what is done for that. Why would a mother use a spiritual healer at home when there is a clinic with licensed physicians and medicine to help? There are so many answers to this question. Many families are very traditional and would prefer to use herbs and natural resources to cure the disease. Some families can not afford the treatment and are no where near a facility to even consider it. As I mentioned in a previous post, facilities are not easy to come by in Ghana. Some families are not aware of what a hospital or clinic can do for them. I am not saying which one is the better option but from my own experience in america, most people do prefer a hospital with physicians and people there to care for them 24/7. I am excited to hear the reasons why a mother would choose one option over the other. This is definitely something you can't research in a library.

Annotated Source

A study was done amongst the under-five population and malaria in Ghana. Malaria accounts for 44% of all out patient attendance and 22% of under-five mortality.  Malaria is caused by a parasite that is passed from one human to another by the bite of infected Anopheles mosquitoes. After infection, the parasites travel through the bloodstream to the liver, where they mature and release another form, the merozoites. The parasites enter the bloodstream and infect red blood cells.

The parasites multiply inside the red blood cells, which then break open within 48 to 72 hours, infecting more red blood cells. The first symptoms usually occur 10 days to 4 weeks after infection, though they can appear as early as 8 days or as long as a year after infection. The symptoms occur in cycles of 48 to 72 hours. In areas where Malaria is common, like Ghana, the residents are primarily immune to the disease. Visitors are a whole other story.

I think I would like to specify my research into what mother’s do for certain health issues. One of these could include Malaria and the check-ups. After reading a couple of articles I found that there is a standard protocol for treating malaria in young ages.

Journal #7

Africa

This weekend I realized how small of a world we live in really is. While at a party I met a guy from Ghana and talked about it with them for a bit. They told me the thing the loved the most about Ghana was the people. They are friendly and welcoming to you despite their living conditions. I can completely relate to this because that is one of the main things people say about Texas. Then on Saturday, while at a house party, I talked to a couple guys whose grandparents both served missions in Ghana. The main point their grandparents stressed was not to eat the vegetables or drink the water. They had a couple of funny stories of missionaries who had been out long enough and thought they could start eating fruits and vegetables and suffered the consequences.

Hearing things about Ghana makes me less nervous to go and making it all the more real. I am nervous about the work load I have to do but in the end it will all be worth it. I still have a to-do list ten miles long but I know that everything on it is critical to my success in Ghana.  In class on Wednesday we did a source analysis web. I realized I need to do more research on the Country of Ghana and more on what issues affect the under-five population.

76 days left!

Journal #6

This week has been more than stressful to say the least. All I can think right now is TGIF. Seriously this week needed to be over like last week. I have had so much happen I didn't even know it was possible to fit that much into one week. Most of the work has been from getting caught up for the prep class and the 1001 things I need to do before I leave for Africa.  My classes are demanding more and more of me which I expect but I feel like all of my professors met together this week and decided to give me as much work as they could. I'm not going to bore you with details but it didn't help on top of that, that stupid Orange County decided to hand out Certified Abstracts of Birth vs Certified Birth Certificates the year I was born. I still have no idea what the difference is but I DO understand that it is making it impossible for me to get a passport which makes it impossible for me to get a Visa which makes it impossible for me to go to Africa. So let's all pray this gets resolved in the next week. Thankfully I have a wonderful Mom that is helping me out through this process. 

I had a meeting with Jackie this week to focus my project and that was such a relief! I have a little more direction to my project. I know that I want to broaden my subject to the under five population's health in the region of Wiamoase. I understand that working directly with these kids will not be possible so I want to go through the mother's decision on the health plan the family has. I found an AWESOME article that really went into depth on reasons why clinics are used or not. Some of the reasons really surprised me. Some reasons were as expected; lack of funds and not having a clinic within distance. Other reasons were more traditional like it is regarded a bad omen if a woman delivers via caesarian section, hence the choice of home delivery. It will be interesting to further research the reasons why a women would choose home or clinic for treatment. In Ghana I will interview the mothers, grandmothers, care takers, husbands on their reasons of how they treat illness or health issues. I am expecting to get a lot of really different answers so as I continue to research I think I'll focus on a couple of illnesses or health issues. Malaria is very dominant there so I might do the treatment on Malaria but then again I don't know if it affects a large percentage of the children. Each time I blog I realize how little I have done and how much I have to do which is overwhelming me to say the least. One day at a time and before I know it I'll be in Africa (if my passport gets here)!

Annotated Source- Eurojournals

This article is exactly what I needed to read.  After a meeting on Wednesday I got a more clear direction on what my project should be.  I want to broaden my audience to the under five population's health.  Working directly with infants and young kids would not be possible so I am going to have to go through the mothers/ caretakers. I would like to see the mother's decision on the type of health care she uses for her children whether that's the local midwife or the town's hospital/ clinic. This article helped me better understand reasons why a mother would choose a certain place to take her children for health.
The main points I pulled from the article were:

- It is often maintained that women’s choices and preferences for location of childbirth are enshrined in society’s understanding of birth as a social process.

-Undoubtedly, the choice of and preference for childbirth location are influenced by the socio-economic factors of the contextual environment in which they arise. Cultural and religious epistemologies shape the demand for health seeking such as the demand for delivery institution.

-In some communities, it is regarded a bad omen if a woman delivers via caesarian section, hence the choice of home delivery.

-Anecdotal evidence among a section of the Akans, a Ghanaian tribe, had it that a woman who experiences prolonged difficulty delivering at home might have cheated her husband through adultery.

-Traditionally, children in Ghana are delivered at home with the assistance of birth attendants or elderly women of the community

-Maternal education has been shown to be positively associated with the utilization of maternity care services

Another important factor in the utilization of maternity care services, especially in Africa is the cultural background of the woman. The cultural perspective on the use of maternal health services suggests that medical need is determined not only by the presence of physical disease but also by cultural perception of illness.

In many parts of Africa, women’s decision making power is extremely limited, particularly in matters of reproduction and sexuality. In this regard, decisions about maternal care are often made by husbands or other family members.

As I look at each reason a women would stay home for care or go to a clinic I see that I have a lot of research to do but definitely would like to keep going on this path on reason's why a women chooses the route for medicine. 

The article can be found here. 

Participant Observation

Setting- Small concert at Velour

Male (25) Chris

Female (20) Kathryn

Female (21) Audrey

Myself (19) Natalie

Female (18) Emily

Chris walked slowly over to group of four girls

The circle opens up to allow him to talk to us

Instant “congratulations” “good job” on performance

Pitch on every girl is increased 

Audrey hugs Chris to show friendliness

Distance is very close, shows our close relationships

Chris nods a lot when he talks to show he is listening

Kathryn touches Chris to show care

Everyone is talking loud because of the loud music in the background

I am crossing my arms and legs- normal stance

I have my eyes on Chris because he is talking

Emily is looking around the room because she has never been there before

Audrey and Kathryn are standing the same way with hands by their side and normal stance

Emily is fidgeting- unsure how to act, not been in a situation like this before

Kathryn, Emily, Audrey, and I are wearing Jeans and casual tops- shows we are comfortable in the situation. Didn’t feel the need to dress up for the occasion.

Our styles are different yet similar in this setting.

Normally Kathryn and Emily wear “California surfer” type clothes

Audrey and I do not unless we are in this setting- somewhat of a façade

Chris is wearing his normal every day clothes even though he is performing

Shows he is comfortable wearing whatever

Our conversation is very casual, we see each other a lot so we ask how each other’s week was, talk about Sunday dinner, talk about other relatives.

We all laugh with each other- comfortable

We all act ourselves when around each other, no one feels awkward. We’re all family.

Our pitch is normal, our conversation gets less and less excited, we are all getting tired.

Comments are made about being tired.

We all decide to go home

It is unspoken about who will go with whom

Unspoken in the car about who will be dropped off first.

Night ends

It was really fun to do this exercise because not only was I able to see how little I normally noticed, but also the interpretations I gave for everything. I don't know if everyone was consciously doing things for a reason but it was interesting to see how we all folded our arms when we weren't talking and used a lot of hand motions when we were talking. The clothes that night were mainly chosen for comfort not impression. The pitch depended on the excitement of the group. If a funny story or memory was being shared the pitch of everyone increased but if a serious topic was being shared the pitch was much lower and the hand motions decreased. I will have to learn a lot of the customs in Ghana because I don't want to do anything to accidentally offend someone. My Grandpa went to Japan a lot for business back in the day and whenever he took a bath or shower it was usually in a tub with other men; normal for their culture. He would imitate their actions precisely so that he wasn't offending anyone. I feel like for the first couple of weeks in Ghana it will be a lot of "monkey see monkey do". I am totally fine with that but I hope I get the hang of things quickly. With lots of practice I will be able to take effective field notes, jottings, and journals. I am so glad that the prep class introduces me to so many different topics that didn't even cross my mind. As I further my research I am able to narrow my topic even more and hope to get a specific audience and topic of research to begin practicing it here in Utah.

Annotated Source- MDG4

For this annotated source I found a powerpoint made for the 3rd Annual Scientific Conference for the College of Health Sciences in KNUST, Kumasi. The majority of it dealt with MDG4, Neonatal mortality, and improving Neonatal mortality.

Welfare of the state depends on the status of reproductive and child health. They are also indicators on the country's socio-economic situation and quality of life. You can see why these two aspects are so important to all countries. Ghana does not have the resources that other countries do. The physician to patient ratio is about 1 to 20,000. Right here you can see part of the problem. 

MDG4 is to reduce the under- 5 mortality rate by two thirds between 1990 and 2015. Many factors come into play with this MDG. Immunizations are a big topic of discussion for the country. There are many diseases that could infect a newborn with such a weak immune system so it is important for immunizations to be given. However, many families can not afford these costly shots. The family size is also increasing in Ghana. By increasing population you increase all types of mortality rates. Unfortunately the developing world is generally not on track to meet the MDG target for under-five mortality.

Many neonatal deaths occur because of prematurity, Asphyxia (deficient supply of Oxygen to he Body), LBW (Low Birth Weight), Sepsis (Blood is infected with bacteria), and malformations/ congenital abnormalities. Underlying factors include poverty, poor neonatal care, under resourced health care facilities, and inadequate neonatal care skills. The country is focusing on spending money on teaching health professionals about neonatal care and how to treat different issues. 

My project will be to primarily observe these treatments and teaching in the hospital. I hope to focus my research on this so that when I am in Ghana I am able to better grasp what is going on around me.

Journal #5

These past couple of days have been busy busy busy. I find myself staying on campus 'till late at night for classes, going home to get food, then returning to the Library to study. I am constantly tired but I can't sleep because I have so much to do. My classes are awesome but so time consuming. I can already tell my Psychology 111 class is gonna kick my butt and I have to study A LOT for my Physiology tests. But even with all of this going on I can't tell you how good life is. Life is oh so good. My classes are mainly medically related classes which makes me so happy. I am FASCINATED with the human body. At 14 I knew I wanted to be a Nurse. At 16 I knew I wanted to be a Neonatal Intensive Care Unit Nurse. This is my fourth semester at BYU and I have learned an immense amount of information and don't ever want to stop learning. I have yet to take a class that I don't see how it would ever help me in real life or my career (ok maybe stats and history classes.. yuck). Now my plans include becoming a certified Athletic Trainer then moving on to do a post-bachelors degree for Nursing and I couldn't be happier with this plan. It is because of my Athletic Training Lab that I am going to Ghana (Thanks Katie!). While I think of my career here in the states I understand that I deal with so many refugees with critically ill infants. That is why I am so excited to go to Ghana. I want to see what kind of Neonatal care they have. I want to experience first hand what a mother does to prepare for pregnancy, delivery, and raising a little one. I want to understand the differences in medical treatments for mothers and infants. Each time I look up articles about Health care in Ghana I am astounded by their improvements in decreasing MMR and IMR. Ghana is still an underdeveloped country but making so much progress. 

My project is becoming more and more about Infant care and a little less about Maternal care. I want to look at Maternal care to get a better look at the Neonatal care because they are so related. The prep class has helped me so much with figuring out my project and preparing me mentally, spiritually, and physically for Ghana. Separating into individual groups is so wonderful because 1) the girls are absolutely fantastic and 2) I learn so much! My mom calls me all the time and asks me what specific things are like in Ghana and at first I knew probably as much as she did… not much. But little by little I am able to answer my "nervous nelly" mom and her thousands of questions. She worries about my safety which is totally understandable but I assure her that BYU isn't going to set me loose in the country of Ghana without any preparation or guidelines. At least that's what I hope… 

I am so grateful for the prep class and all the insight I get and even more grateful the opportunity to go to Ghana and do research. 

Journal #4

In the past couple of classes we have talked a lot about field notes. Field notes should be written in the moment and about everything around you. We practiced this last week in the Wilkinson Center and it was really interesting. We were supposed to write strictly observational notes but it was interesting how I was writing something down and interpreting it. If someone was eating slow I interpreted it as they were not in a rush and not worried about getting anywhere soon. However, in a different country it may be rude to eat your food fast. It's important to remember that your notes have to be strictly observational and not throw in your own interpretation or opinion or this could cloud your research. Over the past week I can't get it out of my head and find myself trying to make strictly observational notes… IT'S HARD! 

I keep writing down things like "Subject is bored" when instead I should be writing down "Subject eating food slowly, not moving quickly, looking around the room." As time goes on I know that I will get better at this and understand that it will take a lot of practice. I'm glad that we did it now because it's really interesting and really fun to practice. 

On Saturday I went to my cousin's concert at Velour and did my participant observation there. It was really cool. My three cousins, sister, and I were talking after the concert and there were so many things that I was looking at it started to overwhelm me and I stopped talking. I AM A TALKER, so I could tell everyone was wondering why I was so quiet. I first noticed the body language, then physical appearances, then motions. It was awhile into the conversation before I started picking up on the pitches, loudness, and actual conversation. 

My cousin's and I are very close and spend every summer together so when we get together we are very casual and ourselves around each other. It was really fun to interpret some of their body languages and take a step back to really watch them and their actions. I keep thinking that I am going to need a lot of practice before I head out to Ghana and know that note taking will be much more difficult in a completely foreign setting with strangers. I need to spend more time developing this skill and hopefully get better at it. From everyone I talk to the people of Ghana are very welcoming and friendly so I can't wait to start my research and hope that I am able to network easily for my project to be successful. It still doesn't seem real but it is definitely on my mind every day and I am constantly looking around and thinking how this particular event would be like in Africa.

Annotated Source

As I continue to develop my research project, I am learning more and more about the health care system in Ghana. This article clearly defined the issues and improvements. Majority of the health problems are due to unsanitary water. Malnutrition, and diseases acquired through insect bites are also very common in that region. There are two organizations on the frontline of battling health related issues; The Women's Health Organization (WHO) and The Ministry of Health. Efforts by both have been made to have cleaner and more readily available sources of water. However, Ghana's health conditions are on the rise. This is most evident in the Infant Mortality Rate. It has been decreasing. 

As I contemplate the final details on my research project, I understand that is important to understand what type of facility I will be working in and what type of health care system, if any, is established in Ghana. I have learned that although there are modern facilities in Ghana, they are not all evenly distributed. Many regions are left without physicians or clinics nearby. Here is where a different type of health care is introduced. Majority of the population live in rural areas and therefore do not have easy access to health facilities. 

It is so hard to imagine a world where a hospital is not easy to come by. 

Health Services near Provo/ Orem

Health Services near Houston, Tx

These are the results by typing "Health Services" to Google Maps. In the Provo Orem area there are at least 45 different types of health services. The main flags with letters on them represent major hospitals in Utah. As you can see Salt Lake City has a number of hospitals that provide excellent care. From Houston Tx, I am surrounded even more health services. Houston houses one of the largest medical centers in the world. In Ghana organized medial facilities are far less common. 

You can see in the Kumasi to Accra region, most of the facilities are in the capital of Accra. The distance between these two places is substantial. With perfectly paved cement roads and speed limits of 60 mph that would be a 3 to 4 hour ride. However, this is not the case for a majority of Ghana, instead there are scooters, buses, and cars traveling on dirt roads that could take up to 8 hours. There are some instances where 8 hours is too long and they die on the way over. As I continue to prepare for Ghana I have to have the mindset that I truly am blessed and realize that I have taken that for granted for so many years of my life. The rural regions of Ghana are of most concern to my project. I am very interested to see what adaptations occur in the health care because of the lack of physicians and facilities. 

Regina Obeng

Regina Obeng. 

In the late 1980's Regina Obeng visited a premature baby unit in Komfo Anokye Teaching Hospital (KATH)  in Kumasi, Ghana. She observed that many premature babies, shortly after feeding, stopped breathing, turned blue, and died. The death of these babies was so common that mothers were asked not to mourn the loss of their infant because it is such a common occurrence and not a big deal. She asked the matron in charge if she could nurse the babies and try to figure out the problem. She was grated permission and with nothing but her midwifery license, she began her research. With only her keen interest and dedication she began attending workshops and learning from pediatricians she worked with. It didn't take long for Regina's soothing presence to make her a leader in neonate care. She has raised awareness all over Ghana that infant death is not inevitable. Obeng wants to promote the neonate specialty to the schools in Ghana so that more will become interested in this special program and help out with the constant demand of neonatal specialists. 

This article really struck home for me because I would like to do Neonatal care and know of the advancement in medicine we have had to make Infant mortality one of the lowest in the world. I was absolutely horrified when I read that the doctors were actually asking the mothers not to mourn the death of their infant because it is so common and not a big deal. What a difference in cultures! This is just something I'm going to have to learn to keep to myself no matter what the situation is. I can't even imagine a kind of world where the mourning over a newborn doesn't occur because of the normality. By researching in Ghana I hope to get a first hand account of the neonatal care. By comparing and contrasting the difference in methods used I can assess where the infant mortality rate is the lowest and how the difference in settings affects delivery and neonatal care.