Swimming and sickling update

G Ketewa at the beach

Last Friday my brother (The World’s Best Uncle – TWBU) and I took AM and his siblings 50 Cedis, G Ketewa and Treasure to the beach. It was a gorgeous day, the waves were just right, the water was sparkling, translucent and a perfect temperature, we had fish and chips for lunch, ice creams on the way home, and everyone had a fantastic time. Except for TWBU, when he had to eat the Bart Simpson ice cream that Treasure licked once and then rejected.

AM took to the waves at the back for five hours, 50 Cedis showed surprising confidence and competence in the smaller waves at the front, and G Ketewa and Treasure grew more and more bold in the shallows.

I mostly left AM to himself – he’s safe in the deep water. The World’s Best Uncle watched the littlies, and I was able to get very wet splashing about in the smaller waves making sure that 50 Cedis didn’t get over-confident and drown himself.

50 Cedis on the boogie board

It was a happy day, and since then Treasure has demanded a return to the beach every time she sees me. She may get lucky, I’m hoping to take her on a few excursions once her brothers are all back at school this week. And it’s very hopeful that she didn’t show any signs of sickle cell pain afterwards (she’ s never been tested for it). She certainly got cold enough to have brought on a crisis, if she had it.

The following day I took Abrantie to a heated indoor pool. This was his compensation for missing out on the beach. We hadn’t taken him because we knew it would be hard to keep him out of the cold water and also because we felt that having responsibility for four non-swimmers at once was a bit too much. Plus I think his frustration at not being allowed to boogie board with 50 Cedis would have far exceeded his disappointment about being left at home.

The pool excursion was a mixed success. Abrantie loved playing in the water and had a great time. But he was very much aware that the friends we went with would really have preferred to go in the big, cold outdoor pool right beside it. Being good friends though, they mostly stayed and played with him in the warm, small pool and one of them even tried to teach him to swim – what a hero.

Typical Aussie beach scene.

To a non-sickler on a scorching day (42 degrees C) the water in both pools felt pretty tepid, but Abrantie’s red blood cells obviously felt differently about it because by the end of the afternoon he was complaining of pain in his leg. Either he’d spent too long in the water or the water wasn’t quite as warm as usual. I felt terrible: guilty that I’d let it happen, sad that  it seemed like taking him to the pool was just too big a risk.

Fortunately, the pain didn’t develop into a major crisis. On the way home in the car I encouraged him to yell and scream and moan as much as he could. I joined in the yelling myself, in Twi and English. Ow, ow ow! Omigod, the pain! Na me adom, awurade, adjee adjee (forgive the spelling, no idea how to write some of these words). He seemed to enjoy this, perhaps because making a fuss about his pain is not really alllowed at home. But I believe in expressing it loudly, providing you don’t frighten other people. It’s not the noise of yelling that’s hurting you, after all.  

Once we got back I cuddled him for a while, then massaged his leg with a hot ointment and gave him some nurofen. His mum, Obaapa is in Ghana at the moment – for Nana’s funeral and also the one year celebration for her own mother’s death – so I reckon he needed a bit of mothering.

Well, one or all of the above strategies worked. I was very relieved the next morning to find out that he had slept ok and the pain had receded. Phew.

Poolside attire for defence against sickle cell. 42 degrees and Abrantie was cold!

I’ve had another look around the web and rediscovered the Sickle cell information centre. This site is a fantastic resource which answers a wide range of questions about sickle cell. Here is some of what they have to say about why swimming in cold water causes sickling crises:

“Cold increases the use of oxygen by the muscles and this reduces the amount in the red cells. Shivering is an example of the extreme of this effect. Cold also causes the blood vessels to contract down and become smaller to preserve body heat. This directly reduces blood flow and any sickling of red cells causes further slowing of flow. The slower blood flow also reduces further oxygen in the blood and low oxygen causes increased sickling.”

 This is good information. However what I’d really like to read is stories from people about their swimming experiences. Is it something people have given up on doing? Or have people found the optimum indoor pool temperature? Can you swim in tropical seas, which are so warm? Perhaps a trip to North Queensland is in order. Sickle cell is bound to become more of a problem in Australia as more Africans migrate here (It’s most common in people of African descent). Perhaps it’s here, where swimmimg is a national obsession, that we’ll come up with some solutions for swimming with sickle cell? Or perhaps I just have to accept that this is one pleasure Abrantie may have to always forego. It’s not easy. For either of us.

Obruni Bank

I’ve received an email from a friend in Ghana who’s just got a new job, six or so months after graduating with a Masters in Engineering. It’s great that he’s got a good job and in his field, especially as it can take a very long time to get work apparently, but I confess I was shocked by the wages.  I knew the per capita income was low in Ghana, but still, I was expecting a graduate to do better:  it equates to around AUD$550 a month (US$360). Yikes, that’s less than I earn in a week, part time.  And I don’t have a Masters, just a BA. It shows up the gap, once again, between our countries and economies.

Compared to many of his countrymen and women, my friend Kwesi is doing well. And compared to a very small number of others, not. Only this morning I discovered, thanks to Qué?, a blogger in Accra, that outgoing Ghanaian President Kufuor has a retirement package worth literally millions more than that of outgoing US President Bush – in a country where the average per capita income of US$1,400 is just 3% of the annual US PCI. Shocked again.

Thinking about these inequities brought my mind back to the day, a few months ago, when I calculated just what it had cost me to live in Ghana for 3 months. It averaged out around AUD$75 a day, which at the time was about the same in US dollars but now is more like US$50. This comes in at AUD$525 per week, a little less than Kwesi’s new monthly income.

AM and his cousin Owuraku working on the dog house.

While travelling I met some Australian girls who’d come to Ghana for three months as volunteers on their gap year between high school and Uni. Travelling in a group of six, sharing beds in cheap hotels, eating street food and travelling in tro tros,  they got away with spending less than AUD$15 a day. Be warned, if you are going to Ghana because you are visiting your in-laws, and with a child or children, you will not be able to do the same. For a start, comfort, safety and familiar pastimes become more important if you have your kids with you, and that will add to your costs. But more significantly, your money is no longer your own.  Well, it feels that way.  As a rich westerner who is part of the family – and you are definitely rich by local standards - you have obligations.

My Ghana expenses included:

• Food – including hotel meals, street food, fruit, birthday cakes and party food, and giving my sister-in-law Serwaa GHC5 – 10 each day so she could cook a morning meal not just for us but for everyone else as well (DadaK footed the bill for the evening meal). One time I tried to save money by going with Serwaa to do a bulk shop at Kejetia market. This did not work out as I’d hoped, she still wanted money every day for the little things we hadn’t bought, like tinned fish and tomato paste.
• Gas for the gas cookers. DadaK paid the elecricity costs.
• Filtered water, including both bottles for the water cooler and for sachets before we got it working. DadaK paid for the rest of the water that was bought from a neighbour who had a bore.
• Mosquito net, pillows, toilet paper.
• Gifts, gifts and more gifts for all the family in Kumasi, the village and Accra, and a few neighbours, including cloth or clothing for everyone in the Kumasi household, occasional treats such as chocolate or bread or soft drinks, exercise books and pens for everyone under the age of 25, rebuilding the roof of AM’s cousin Afia Serwaa’s hair salon, and of course cold hard cash (which in Ghana is limp, crumpled, dirty and even sometimes counterfeit).
• Travel within Ghana, by tro tro, taxi or private bus service for long distances.
•  Cloth, clothes and souvenirs for me and AM and for family and friends back home.
• Mobile phone and lots of credit – mostly so AM could call friends in Australia on a regular basis. I gave the mobile to Maame Yaa when we left. It’s hard to believe, but AM is one 14 year old not addicted to online chat, messaging, Bebo etc. I, his middle aged mum, am the one who does that kind of stuff (not Bebo, ok, I use Facebook). So he had to be able to make calls, in order to get some respite from his culture shock.
• A new laptop cable that I promptly lost after spending weeks trying to find one to buy. This included a tip for the guy who helped me locate it. Luckily the old one held out until about two weeks after we  got back to Oz.
• Swimming pool entry occasionally, internet cafe charges, books, DVDs (they’re very cheap there).
• Timber for AM’s woodwork project – a dog kennel, and money well spent in spite of the fact that the dogs didn’t want to sleep in it.
• Payment for the lost-wax bronze casting workshop AM did at Kumasi Cultural Centre. Ironically, he mostly created nasty weapons which we didn’t try and bring back to Australia, but gave back to the bronze boss, who incidentally turned out to be married to one of DadaK’s in-laws. In Australia, this would earn you a discount. In Ghana, it seemed to mean we ended up paying more.
• Paying all the expenses of everyone who accompanied me anywhere, with a few notable exceptions, like my engineering friend above. This is one of the reasons we didn’t travel around very much.
• A few nights hotel accomodation when we went on our trip north.
• Medical expenses when AM was sick. Not enough to bother the insurance company with, but it all adds up.
• Nana’s wheelchair.
• Dash (tips).

It did not include:

• Air fares, vaccines, anti-malarials & other meds, visas, travel insurance.
• Getting all my photos developed back home and posted back to family and friends in Ghana (don’t laugh!).
• The interest on the debt I managed to accrue while away – surprise, surprise -  and am still paying off.
• The cost of all the clothes, shoes, books and other items I left behind or gave away.
• Postage on a couple of small stools I got sent back to me in Australia – aaargh! Never again.

My expenditure has no doubt been good for the Ghanaian economy, albeit in a small way. It was certainly good for the family and for Nana, although I think it gave them a vastly inflated concept of how much money I actually have.

One Ghana Cedi, featuring past Presidents. The bottom one is a fake that our neighbour got in her change one day.

Financial obligations play an important part in family relationships in Ghana, and probably much of Africa and the poor world. It’s interesting to note Barack Obama’s Kenyan relatives’ expectations. The Sydney Morning Herald reported that “in Kogelo, birthplace of President Obama’s late father, many hope the inauguration in the US of a Luo will bring running water, a paved road and a police station. Tribal tradition dictates that those who find wealth or power should share it with their clan.” I can’t help wondering in what ways exactly he will fulfill his obligations and at what point, if ever, enough will be enough. (And also whether that’s a reason why Kufuor got such a massive payout – for all the rels. Still doesn’t justify it, though, in any way.)

DadaK has been sending money back to his mother ever since leaving Ghana in the ’70s, and it seems like the money has mostly vanished. Apart from the house we lived in, and perhaps a few nephews’ improved education at boarding school, there’s nothing to show for it. Family members to whom he sent the money almost always seem to have had different agendas to him for how it would be spent. I don’t find this surpising but he finds it infuriating. As well as that, his cattle all died (allegedly killed by eating  from the village dump); the well he built was neglected because his brother wanted to charge the villagers for access, then was superseded by a new government well; and the gun he bought so they could hunt bush meat was used to pay someone’s debt.

Periodically I’ve helped out, usually when Nana’s been ill; I haven’t financed any money-making or philanthropic projects. My latest donation was for Nana’s funeral expenses. I don’t expect it to be my last, however. Apart from anything else, one of AM’s cousins has been named for me, so I now have an obligation to send gifts to her.

This financial drain can cause conflict in mixed relationships if it’s not carefully managed, and it can become even more stressful if you actually go and visit the family. DadaK was constantly worried about money while we were there, because he felt that the family were expecting total financial support from us but not being completely open about their own sources of income. I was worried about money too, but of course I also had white guilt to contend with, which made it harder to be firm about what I was prepared to give. Knowing that the average weekly wage was less than I earn in an hour, how could I not share generously with AM’s blood relations?

My namesake in Mensakrom, in a dress I bought for her.

However as the weeks in Ghana passed and my bank balance dwindled I too started to get tetchy about money, to the point where I was only half joking when I called myself the Obruni Bank. (Obruni means white person/foreigner). The family found the term hysterically funny, probably because I was naming the truth. In fact Obaapa almost beat me too it a few years before, by nicknaming me Afia Sica (Afia=Friday-born female, Sica=money). I’d just like to say for the record here that my income is pretty average and I probably earn less than most Ghanaian-Australian taxi-drivers. Perhaps that’s why I don’t find this nickname as amusing as the one I invented myself.

White guilt reality check: no matter how much money I pour into my Ghanaian family, it’s not going to change the global economic system and power structures that create such inequality – and I have my own life to support here in Australia, where my weekly rent costs about 30% of the Ghanaian PCI, and almost half of my weekly wage (which is why I have a flatmate!).  I need to also remember that although sometimes it looks like they only want me for my money, there are real bonds of love and friendship between me and my Ghanaian in-laws.

I’ve written all this because money’s  often an issue in mixed relationships where the partner’s from a poor family in a poor country, but it doesn’t get talked about much at all. I strongly encourage non-African partners /parents to go to Africa and meet your in-laws, especially if you have children, or are planning to have them. It’s a wonderful, rewarding thing to do that will give you great insights into your partner’s culture, values and family idiosyncracies. But you do need some warning about potential challenges, and the money stuff is definitely a big one. Don’t let it hold you back.

I also wanted to give you some idea of what the real expenses are, of this kind of travel. I suggest that if you are visiting poor relations in Ghana – or probably anywhere in Africa: examine your budget carefully, establish early on how much you are able to afford to fork out in expenses and gifts, make that clear to the family, and staunchly ignore any twinges of guilt about your little forays to the pool or lashing out on souveniers. That’s what I plan to do next time – I wonder if it will work?

Swimming and sickling

4 years old x 4 metres deep

I’ve been thinking about swimming. We’ve just spent a few days up the mid-north coast visiting my parents – which means going to the beach every day for a swim. It used to be twice a day for hours and hours, but adolescence seems to have given AM an allergy to exercise, and now when we stay at the coast it’s once a day for a quick surf and that’s it.

Just as an aside, my boy told me he doesn’t want to be called ActionMan in this blog. In just one short year it has become a misnomer anyway. So until I can think of something more catchy, (that he approves of) he’ll just be AM – which also happen to be two of his initials. Perhaps they could also stand in for AdrenalinMan – his idea of fun these days would be Parkour (if he could persaude some friends to do it with him), parachuting and wing-suiting.  Eeeeek! What’s wrong with good old soccer?

But back to swimmimg. AM truly was an ActionMan from a very early age. I love swimming myself and I’d take him to the pool or beach often when he was little. The picture shows him swimming in a 4 metre deep pool just a few days after his 4th birthday. From the age of about 7  he had surfing lessons every summer.

I’d love to have been able to do the same with DadaK’s children, but as more of them kept arriving on the scene, it became increasingly difficult to manage. Taking a bunch of non-swimmers to the pool without another adult handy is a recipe for disaster.  So none of them can swim. Every summer I hope to rectify this situation at least with the oldest, 50 Cedis, and every summer we don’t quite make it.

I did take him swimming in Ghana, but it was an expensive expedition to go to the pool so we didn’t do it often enough. In Kumasi the only pools we found were attached to hotels. The Kumasi Cultural Centre gave me a list of them, and we went by tro tro and taxi to two that were – kind of – close to where we lived in Asuoyeboah. We went to the Wadoma (off the Sunyani road) and Rexmar (Patasi) hotels.

The joy of burgers

I felt I couldn’t just take AM, but also had to take his cousim Owuraku, 50 Cedis and usually one of his other brothers. AM, pining for non-Ghanaian food, wouldn’t leave the premises without having eaten at the hotel restaurant, so everyone else would have to as well, and I rarely got out of it having spent under $60 – comparable to Australian prices. The picture at right shows 50 Cedis’ rapture at the prospect of the Rexmar’s hotel’s unique mini-burgers and chips. 

We managed to nearly drown Owuraku at the Rexmar pool, which has a very deep spot, but he and 50 Cedis both had a lot of fun at Wadoma, which is shallower, and one of the days we went they got to join in a riotous ball game with some young men who were there. (Who were quite drunk, so I had to keep a vigilant eye on my non-swimmers).

To be frank, 50 Cedis probably would have learned to swim years ago if he wasn’t such a panic merchant. AM hasn’t helped much in this regard; his sense of fun in the water is usually interpreted  as plain sabotage by non-swimmers. In the picture below you can see 50 Cedis enjoying a panic in about 1 metre of water. Perhaps Drama Queen is a better description. But with four siblings and non-swimming parents, the odds of him getting the aquatic attention he deserves have been slim.  Maybe this summer we’ll manage it.

I think swimming is such an important part of Australian culture the government should ditch the controversial citizenship test and just teach all new migrants swimming and water safety. I’m sure it would be more popular. Like barbecues, swimming is a part of our culture that most migrants embrace with enthusiasm – if not for themselves, at least for their children. We even have an Australian designed Burqini – “dynamic swimwear for today’s Muslim female”, just to make it accessible for everyone.

Even DadaK has expressed interest in swimming in the past. Not long after we met I took him to meet my parents, who were then living on the shores of a beautiful tidal lake on the south coast of NSW. I tried – unsuccessfully – to teach him to float on its shallow, sandy waters. In spite of his complete failure to float, it was fun – until the next day, which he spent moaning and writhing in bed, and I spent not wanting to believe that swimming had brought it on. This was my first encounter with a condition I’d only read about in high school biology text books, but neither of us knew it at the time: sickle cell disease.

Sickle cell disease is a genetic blood disorder in which lack of oxygen in the red blood cells – triggered by a range of things, including dehydration and getting chilled – causes them to ’sickle’ in shape and break down and block blood vessels. The main symptom is incredible, unbearable  pain as the surrounding area is starved of oxygen. The damage ranges from heart attacks and strokes to permanent bone damage to stunting children’s growth.

It took us a few years to get a diagnosis on what DadaK spoke of as his ‘unmentionable’ because his mother had told him never to mention it or it might come on. When feeling daring, he’d call it his rheumatism. These days he’ll refer to it as sickle cell, and still suffers the consequences of a life time with the condition, although fortunately he hasn’t had a severe attack for many years because he’s found a medication that helps stave it off when he feels it starting.

So, I mentioned it was genetic, right? Depending on the combination of genes you get, you can have no symptoms and just be a carrier, or you can have extreme symptoms – worse than DadaK’s. You can only get symptoms – generally – if both parents have a gene for it. And guess what. Out of all the women available, DadaK married Obaapa, who carries a gene for sickle cell.

They have been incredibly lucky really. Out of their four children, so far only Abrantie has been diagnosed with the condition. 50 Cedis and G Ketewa are only carriers (as is AM), and no-one’s been brave enough to test Treasure’s blood, but so far she’s not showing signs of it. Abrantie’s got the same genetic variant as DadaK – bad, but not as bad as it might have been. Bad enough tho, to make swimming a bit of a challenge.

It was taking him to the beach when he was about 18 months old that alerted us all to the fact that he had sickle cell. I got a call from DadaK in the evening afterwards, wanting to know if he’d hurt his leg because he was complaining of pain. No, I said, but could it be sickle cell? It sounded like it. (By this time I was somewhat of an expert on it, having been through quite a few ‘crises’ as the pain episodes are called, and hospitalisations, with DadaK). Obaapa was firmly in denial, DadaK  wanted to be in denial  but couldn’t help admitting that I might be right. A few months later (after another swim) Abrantie had another crisis and sometime the following year or two, he was hospitalised with it and diagnosed. This time swimming had nothing to do with it, to my relief, but you can understand I’ve been pretty wary of taking him to the pool ever since.

Looking into it online I’ve found that people with sickle cell can swim, but it must be in warm water and they have to keep their fluids up – and in my experience, not get chilled. I turn into a monster of anxiety when I take Abrantie swiming: Is the water ok? Are you warm? Are you cold? Do you want a drink? Where’s the towel? Wrap up really well. Are you cold? You’d better get dressed. Oh my god who got your T-shirt wet!? Are you warm enough? Have a drink. 

It’s paid off in one respect, because he’s never had a crisis after going swimming with me, since those two early incidents – and he loves being in the water. But it’s another reason why no-one else in the family’s learned to swim. Sickle cell just complicates the picture. I find it very sad.

I did a quick look around the web for useful sites but decided to just link to two that are for kids, which I intend to show Abrantie. Check them out.

http://www.sicklecellkids.org/sicklecell_temp.html

http://sicklecell.starlightprograms.org/