Cushioning Cultural Shocks: Guidelines For Volunteers To Ghana
By James Clarke, MD, Medical Director and Ophthalmologist, Crystal Eye Clinic, Accra, Ghana; Unite For Sight Medical Advisory Board Member; Unite For Sight's Leader of Ghana Programs
Ghanaians are very hospitable and kind, giving rise to the adage of the proverbial 'Ghanaian Hospitality.' The average Ghanaian you will meet will be ready to offer a helping hand, many of them, without expecting any reward in return. Some will however expect a reward in return. This will not be made known to you initially. It may therefore come as a shock when it is made known. Do not get upset if you cannot meet the demand. Politely tell the fellow that you are not in a position at that moment to help him or her.
Many of the areas where you will be working are relatively poor. The people in these areas will therefore see your coming as a solution to their poverty. They will therefore lay everything aside and wait for you to provide them with everything, sometimes even their daily food. Be cautious in making promises. Remember you cannot solve all their problems in the short time that you are with them. If not certain about what to do, ask a local person who is a member of the team.
Many people see the expatriate (you) as being very wealthy and therefore capable of affording everything. Expatriates tend to get higher quotations for goods and services without being given the opportunity to make a cheaper choice. Do not get upset at this. It is because people generally have respect for the expatriate and think that he/she deserves the most expensive, not necessarily the best quality.
At the open market place, prices quoted are often not final. One has to bargain to beat the price down. Begin by offering 1/2 of the stated price. You may carry the day. If not, a few minutes of friendly bargaining will yield good results. If you are not used to bargaining, you may go to the market with a local person.
A few examples:
- After offering free screening in a community, John an expatriate volunteer strikes an acquaintance with Jack, a local student. In their conversation, Jack makes known to John that his mum is on admission in the hospital in a nearby big town. John shows sympathy towards Jack. Their time of contact was short, so Jack collects John's email address. A few days after John returns to his country, he receives an email from Jack, asking the former to send X amount of money because the mum is in coma and without the money she will not be treated. In situations like this, nothing stops you from helping out if you feel convinced but refer the matter to a local team member.
- Sister M, an expatriate volunteer, meets Sister P, and they become friends for some weeks. On the day of Sis M's departure to her country Sis.P solidifies their friendship by buying a gift for M to take along. M is very happy. A few weeks after arrival, Sis M receives a letter from Sis P announcing her (Sis P's) grandmother's death and therefore needs money to enable her attend the grandma's funeral.
- Patients are screened and those having cataracts and needing surgery have been identified. Arrangements are made for transportation and lodging to a far off center for the surgery. The patients tell the expatriate volunteers that when they go outside their homes, they cannot afford food. It thus becomes a burden on the volunteers to provide free screening, free transport, free lodging, free surgery, free medication and on top of all that free food. Remember that the patients were eating before your arrival. They will want to stretch your generosity. It is advisable to find out from a local team member what the people can afford for themselves. Do not take up the whole 100% of the burden. Otherwise, you will be frustrated.
Remember also that even though people are generally, poor they still want to preserve their dignity. Valuable/expensive things offered on a silver platter tend to lose their value and have the tendency to be abused. Thus it is always advisable to let people bear some responsibility. This is why some communities have to pay a token fee for some of the services or medications. No matter how meager a fee paid, it is enough to let one value whatever is offered. In the same vein, minimize or, if possible, avoid the use of the word 'free'. Better to say someone is paying for it or Unite For Sight is paying the difference. If something very expensive is being offered for free, the notion is that it is meant to be thrown away; and that is why it is being given to them. They may even feel belittled by the totally free offer.