In September-October last year I spent six weeks volunteering at the Ghana Homeopathy Project’s busy Hope Clinic in Mafi Kumase in the Volta Region. The clinic is run by former water engineer and talented homeopath Samuel Tsamenyi, known as Emperor (a nickname from his school days), whose reputation brings patients from far and wide. He is assisted by two full-time clinic staff, Precious and Xoese, and a very enthusiastic group of homeopathy students.
The Hope Clinic provides low cost health care for the 2,500 residents of Mafi Kumase and for the surrounding region, with patients coming from as far afield as Ghana’s capital, Accra and including nomadic herds-people from neighbouring countries.
After practising in the UK for nearly 20 years where patients book their 90- or 45-minute appointments in advance and are seen in a private, uninterrupted space, homeopathy in Ghana is full of surprises.
Consultations are often a lively, social affair as patients gather on the veranda without appointments to wait their turn, and people wander in and out of the open door. The mobile phone rules, and people will interrupt consultations to take calls. Most consultations are conducted in the local Ewe language with the clinic staff or students translating, and if they weren’t available, a neighbour or another patient might be called in. It was a little surreal one afternoon watching a local farmer interpret for a young woman from Niger whose consultation followed his. At other times, in the absence of an interpreter for patients from outside Ghana, we managed to prescribe successfully on very few symptoms explained with a lot of gesticulating and pointing. It is not uncommon for people to go and lie down for a while after taking their remedy, and we would generally see an improvement by the time they left.
Despite the opening hours on the roadside clinic sign, patients will turn up at any time, day or night, emergency or not. I was woken one night by a young man shining a torch through my bedroom window and it was my turn to knock on Emperor’s door and say, ‘we have a patient’! The man was having palpitations and was very anxious. It transpired that he had spent the day working hard making the local tipple, palm wine, and while he hadn’t drunk any, he had in fact given up palm wine some months previously after a heavy drinking session had caused palpitations. We gave him Nux Vomica – a fantastic remedy for adverse effects from alcohol.
Sometimes people travel long distances to the clinic, often on motor bikes. People also come for pregnancy testing, to have their BP or blood glucose levels checked or for wound dressing. Each day several patients will test positive for malaria. Many people are unable to access conventional health care, often not being able to afford the long journey to the nearest hospital, let alone the treatment when they get there.
It was necessary to work flexibly, to do the consultation out at the car or to make a house call if the patient was very infirm, to work by torchlight during ‘lights off’ (the frequent power cuts), and some consultations took place on the veranda, including during the night. It was not unusual to return sweltering from a long walk, a trip to the crowded market, or a stint shovelling sand for the kids as they worked hard to fill the foundations of a new clinic building, in desperate need of a cold shower and find myself instead summoned to the clinic.
We saw some fascinating cases and had some very quick results. One of my favourite cases was a 3-year-old girl who was in a very distressed state with fever, delirium and abdominal cramps. Her malaria test was positive, and we treated her on the basis of her symptom picture. There was a torrential downpour for several hours and the moto (motorbike taxi) failed to collect her and her grandmother, so that night they stayed and slept on the floor. The grandmother was too worried to eat, and I eventually went to bed with some trepidation wondering what we would find in the morning. Emperor checked on them during the night and they slept soundly. In the morning the little girl was sitting on her grandmother’s knee full of smiles eating breakfast before eventually going home on the moto. It was an absolute delight to see them for a check-up two weeks later, the little girl smiling and well.
Another case that we particularly enjoyed was that of a lovely young woman who presented with life-long nocturnal enuresis (bed-wetting). It turned out that she had been abandoned by her mother as a baby, so this is what we treated. A week later, the patient and her husband reported that the night of the first remedy ‘there was a downpour’ (a great example of a homeopathic aggravation)! This was followed by a steady improvement with reduced quantity of urine and two completely dry nights – the first ever! The remedy was repeated, and the patient returned weekly reporting a steady improvement. After two months of treatment, her life-long problem had resolved.
While cases in the UK often have a strong psychological component, like the one I’ve just mentioned, many of the patients at the Hope Clinic present with physical symptoms such as back and joint pain from years of hard work farming or carrying heavy loads on their heads as market and street traders. Many women have had multiple pregnancies, often with the loss of one or more children. A lot of people complained of heart pain, many of palpitations and many had hypertension. We treated a 4-month-old baby with whooping cough which started a few days after his third pertussis vaccination and I spent an enjoyable couple of hours sitting on the veranda holding him as he, and his mother, caught up on some sleep.
Many people came having been to hospital with no success, including a young woman with severe asthma who was six months pregnant and arrived on the back of a motorbike during the night on a couple of occasions. A five day stay in hospital made no difference to her symptoms. Once we added chamomilla to her remedies (a great remedy for women during pregnancy) she responded much more quickly to treatment. It was very gratifying also to hear that a patient from Accra had called in to thank us for the improvement in his symptoms. Many years of conventional medicine had not helped him.
It was a joy to see people responding so quickly to remedies, to work in an environment where homeopathy is valued and trusted, and to treat so many patients of all ages and from various walks of life. It was also a huge learning experience to be prescribing for conditions that are usually seen by medics in the UK and I was very pleased to be able to work collaboratively with Emperor who has so much experience. The students arranged two outreach clinics, one in a welcome breeze under a tree in a village some 20 minutes’ drive away, the other in a room at the bustling station in Sogakope on the Lower Volta. On both occasions, patients were waiting to see us when we arrived, and the consultations followed in quick succession.
It was a delight to get to know the students. They are all very dedicated, with Precious and Xoese working in the clinic six days a week and most of the other students teaching at the local secondary school and giving up their free time to gain experience in the clinic, help with interpreting, and join me for some classes – when these weren’t rained off. The monsoon rains are impressive and provide a welcome relief from the heat! The students are a strong testament to the benefits of gaining early clinical experience and it is they who will make homeopathy sustainable in Ghana. I was as impressed by their competence as I was by their dedication and enthusiasm.
There were some challenges. For the first few days working in both a new clinical situation and a different culture, my head was in a whirl. There were numerous occasions when I didn’t have a clue what was going on. Without Emperor, Precious, Xoese and the students, I would have been totally at sea. Being an interpreter is a job that takes a lot of skill and an equal amount of patience, especially as one tries to get to grips with the nuances and peculiarities of a homeopathic consultation, and again I think the students are to be congratulated on how they manage this.
I was surprised how much, especially as time went on, I struggled with the heat and humidity. This was worse than the mosquitos, who seemed to quite like me. There is a strong emphasis on death in Ghana, with ambulances, sirens blaring, bringing bodies home from the mortuary on Friday evenings for huge funerals every weekend. Watching a green mamba slither away from me was exhilarating, as was sitting in pitch darkness during ‘lights off’ watching the biggest electrical storm I’ve ever encountered and periodically jumping out of my skin. Not knowing when I might come across another snake was disconcerting and learning the morning after the storm that a boy had been struck by lightning was sobering. At times, the traffic (the speed, the unpredictability, the state of vehicles and roads) completely freaked me out and I wondered if I would make it home.
Aside from that, volunteering at the Hope Clinic was an experience not to be missed on so many levels. Emperor is great fun to work with. I was so well looked after by his niece Anita, by Precious, Xoese and the students, and by Richard (18) and Kafui (8) who became good friends, teaching me to speak some Ewe and taking me on fantastic walks around the area. Ghanaian people are incredibly welcoming and friendly and there were many lovely encounters.
Six months later, I’m still missing Anita’s excellent cooking, the fascinating early morning walks, the camaraderie in the clinic, the patients, the challenges (in a good way) of learning a new language, listening to reggae and watching the world go by with Emperor and others at the roadside, and most of all, the fantastic people I got to meet and spend time with. I hope I’ll be back there before too long!