Posted to journeytosolidarity.org by Jay Breitlow.  Photo courtesy of the author.

Baby Jamani and Poppa Jamani getting a little J2S love!

Baby Jamani and Poppa Jamani getting a little J2S love!

What started as an idea over a year and a half ago, has finally manifested as reality.  Yesterday a letter came in the mail from the Internal Revenue Service (IRS) that reads:

“We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)3 of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code.”

So what does this mean?  It means that for those of you who were bold enough to gift J2S with a donation this year, you are free to claim it OFFICIALLY on your taxes.  For those of you who were waiting in the wings to donate until we were an IRS proclaimed charity, please donate now in confidence.  Gifts in kind and monetary donations are tax-deductible to you, depending on your tax situation.

We had a very strong feeling all along that this was going to be the outcome, but until this letter came in the mail, there was nothing official.  THANK YOU all for your support, please stay tuned for an exciting announcement regarding a fundraising campaign and next location… as this is you and your gifts that have made this ALL possible.

From myself, the board of directors, the entire Journey to Solidarity team, and the countless 1000′s of people you have reached in Africa…  Medasi paaaa (Thank you in Twi).

Tags: 501c3 chiropractic, africa, africa chiropractic, AIDS, Chiropractic, chiropractic mission, chiropractic mission trips, chiropractic missions, chiropractic non profit, Chiropractic Nonprofit, donation, Ghana, ghana chiropractic, Ghana volunteer, Health, Health mission, HIV, HIV AIDS, innate, jay breitlow, Journey, journey to solidarity, NonProfit, Service, Solidarity, volunteer, wellness

Jay on June 1, 2009

Posted to journeytosolidarity.org by Jay D. Breitlow.  Photos courtesy of the author.

The team at HardtHaven

The team at HardtHaven

The last weekend in Ghana, proved to be one of the most moving and potentially positive with respect to a future J2S location. The destination is a small town called Kpando, which is about a 4 hours drive north out of the streets of Accra through lush green African bush and rolling hills. The reason we were travelling to Kpando was because a good friend of mine from Iowa, Jess Crawford, had spent time there volunteering at an orphanage called HardtHaven.

Jess has been to Hardt Haven several times, and she, like me, was also getting ready to depart from Ghana, so she really wanted to say ‘goodbye’ to all the children. What she didn’t know was that she was also making an introduction to Journey to Solidarity and that as a team we live to ‘lovemark’ children. Joining us on the trip was a regular patient and friend of mine Mari Lise and the always-dependable Dr. Hunter.

Baby Christopher.  This guy is a tank and the largest Ghanian baby, perhaps ever!

Baby Christopher. This guy is a tank and the largest Ghanian baby, perhaps ever!

Reasons vary for why children in Ghana become orphaned. Some are orphans because they are born with HIV/AIDS, and when the parents find out, they are essentially abandoned. This goes back to the idea that children born in Africa with a mental or physical illness are essentially outcasts.

This is not the case with everyone though, and there are some children who are loved by their parents regardless of their birth abnormalities. Other children become orphans because many parents in Africa die early from AIDS and leave children homeless. For whatever reason, the many children that end up orphaned in Ghana become part of a statistic. There are 1.1 million orphans in Ghana and with a population of just over twenty million that means that somewhere around 5% of the population exists as orphans. The message: There is a great need in Ghana for loving people with big hearts. One such person is Joy Hardt who started the HardtHaven orphanage.

Dr. Hunter at work.  Dr. Jay and Sonjelle in the background.  Notice the village children peering through the fence

Dr. Hunter at work. Dr. Jay and Sonjelle in the background. Notice the village children peering through the fence

HardtHaven is a small orphanage dedicated to improving the health and lives of Ghanaian children afflicted with HIV/AIDS. In Ghana it is estimated that over 17,000 children are born and living with the infection. It is commonly thought that because of the infection, these children are living out a death sentence. However, antiretroviral treatment in combination with modern sanitation and nutrition has demonstrated that a percentage of these children can, and do, live a normal, healthy, HIV/AIDS free life. I am no expert on HIV/AIDS, but I do know that if there is a real chance for children to escape this normally deadly disease, well then I should do everything in my power to give these children that chance. As a team, we at J2S are afforded this chance.

The first opportunity to make a difference to these children came this weekend at HardtHaven, where there are 20 children between the ages of one and 16 living. All the children are native to the Kpando/East Volta region.

Blowing bubbles at HardtHaven

Blowing bubbles at HardtHaven

When we showed up as a team, we were just trying to help in some small way: Christina and I adjusting the children; Mari Lise and Jess playing ball and blowing bubbles with the younger children and the other volunteers playing referee and learning about a nervous system free of interference. The bright and powerful Ghanaian sun stopped nobody as Frisbees and smiles flew with little regard to whom or where they were thrown. It was altogether wonderful and to make it just a little better, everyone received the power of the adjustment.

Baby Wisdom cruising Kpando floors.  Heart this little one!

Baby Wisdom cruising Kpando floors. Heart this little one!

At the end of the day when we headed back to Accra, we left with a sense of accomplishment and sadness. There was the feeling of accomplishment and happiness that we were able to make the lives a little bit better for two dozen wonderful, vibrant children; at the same time we were all a little sad that we couldn’t help out a little more. This sadness was temporary; the director of HardtHaven, Sonjelle, called later in the day and told us that for the first time in his short life, little baby Wisdom had taken solid food. This response was much in the same way that (if you have been following previous logs) Annabelle had responded to her first adjustment or Harriett when she started playing with young children again. It’s great when you can make a difference to children at the moment, but when you know for certain that your gifts transcend time and space, you can’t help but smile a little wider and become a bit more driven to make a difference.

Sojelle at HardtHaven with some of the young Children

Sojelle at HardtHaven with some of the young Children

The relationship with HardtHaven is young but very promising. Interestingly enough, two days after we returned to Accra I had a flash that in the future I could live nearby and provide care for the children and know how their bodies and immune systems respond to consistent and specific Chiropractic care. Literally within the hour my phone rang, and it was Sonjelle calling from HardtHaven. She said that she was speaking with the other Director, Edem (who is also a native Ghanaian) about how to get care provided on a regular basis. Coincidence? I think not. The world is deeply connected and here is yet another perfect example of how it works.

Currently we are looking at logistics to bringing Chiropractic care to HardtHaven and are open to suggestions and doctors with big hearts. There is certainly going to be a return trip to Ghana but exactly how and when is uncertain. I return home to the good old US of A this week and am excited to see how the universe responds to all our requests.

http://www.unicef.org/infobycountry/ghana_statistics.html for info on the Ghana HIV/AIDS and orphanage data.

For more information on HardtHaven visit http://www.hardthaven.org/

Tags: africa, africa chiropractic, AIDS, Chiropractic, chiropractic mission, chiropractic mission trip, chiropractic mission trips, chiropractic missions, Chiropractic Nonprofit, christina hunter, donation, Ghana, ghana chiropractic, Ghana volunteer, Hardt Haven, HardtHaven, Health, Health mission, HIV, HIV AIDS, innate, jay breitlow, Journey, journey to solidarity, Joy Hardt, NonProfit, orphanage, Service, Solidarity, volunteer, wellness

Jay on May 6, 2009

Posted to journeytosolidarity.org by Jay D. Breitlow.  Photos courtesy of the author.

Lovemarking a patient in Kumasi.

Lovemarking a patient in Kumasi.

This week, I closed the Outreach clinic in Accra early, so that I could make the arduous and, I later found out, often perilous journey north to the city of Kumasi.  Before I begin, I must introduce Dr. Robert  Champagne.  Dr. Robert is from Canada and transitioning from several successful decades in practice to the non-profit Chiropractic world.  Essentially, Robert is to “Chiropractic for the World Foundation’” what I am to “Journey to Solidarity.”  Two non-profits each based out of North American countries and both focused on the long-term development of Chiropractic abroad.   We had a brief email exchange before his flight to Ghana, in which he explained his purpose for coming, and “Hey can you help with a few logistics?”  Largely, he came to research Ghana for his new Non-profit and to check-in on their team’s project to help build a school.  Coincidence we just “happened” to meet in Ghana?   After reading this story you will know that answer is “nope.”

Dr. Robert, Father Moses, Dr. Jay

Dr. Robert, Father Moses, Dr. Jay

Kumasi is the traditional seat of power for the Ghanaian ‘Ashanti’ people.  Steeped in history, the area is still ruled by a traditional king, who as of this week has adorned the seat of power for ten years.  The king sits on the throne bequeathed in layers of gold necklaces, anklets, earrings, and bracelets that traverse the entire length of his thin, leathery forearms.  Atop his head sits a rather simple, albeit oversized, crown.  The man wears more bling on his body for formal occasions, than the entire West Coast rap scene does together on a Saturday night.  

This demonstration of wealth is not indicative of the typical Ashanti people, who are humble, full of life and largely monetarily underprivileged.

In fact, a general rule of thumb is that the further north you go in Ghana, the poorer the population is.  Kumasi is about half way from Accra (the southernmost part of the country along the Gulf of Guinea) to the Northern border of Burkina-Faso (the country just north).  The sights and sounds of Kumasi are anarchic as cars, goats, people and oxygen fight for space.   The signs are abundantly clear: I have entered into a significantly more impoverished part of Africa.

Once here I was hoping to find people who needed to receive a Chiropractic adjustment for the first time in their life.  Since the population of Ghana is 20 million and there are almost zero Chiropractors here, finding people like that should not be a problem.  

 The School that Robert and his team are helping to fund.  J2S pitched in by raising money this week in Kumasi

The School that Robert and his team are helping to fund. J2S pitched in by raising money this week in Kumasi

However, both Dr. Robert and I wanted to be sure that we were educating people about their health, not just giving away adjustments.  What we found was this: people were willing to line up for over an hour for the power of an adjustment, even if it meant standing under the scornful eye of the unrelenting Ghanaian sun.

Fate seems to have an interesting sense of humor because as relative strangers who just met, Dr. Robert and I adjusted just under 200 people together in about an hour and a half!  We were only focusing on the upper thoracic and cervical spine for several reasons. 1) Time 2) That is where most of the power of the human body comes from and 3) People in this part of the world generally respond better, and quicker, to adjusting only a few segments.  This volume of people can give you an idea of how well we work together as doctors and friends, yet think of what can happen when we are able to work together as Canadian and American non-profits.  It is a very exciting time for both of us, and this new partnership, I am confident, will exist for years to come.

To get to this point, we had a great deal of compassion and help.   Our contact in Kumasi was a Catholic priest and educator named Father Moses.  Father Moses is a truly blessed and unique person.  First, his presence in front of church demands immediate respect and purposeful attention.  When I first saw him, he was dressed in his clean white church robe and dark, horn-rimmed glasses speaking to over 700 women about their faith and family.  Rumor had it, this man was jovial and friendly, but from his ardent sermon, which was delivered with an undertone of damnation, you might never guess that.  However, once I spoke in person with him, it was clear to me that I was the only person in the world that mattered to him at that moment.  Later that week, I would witness the good priest open a bottle of Guinness beer with his teeth.  Truly a humanitarian and perhaps the best preacher/teacher/bottle opener in the history of the world!!

After the sermon, Fr. Moses began the introduction of Dr. Robert, Chiropractic and me.  The man had, at this point, been adjusted several times by Dr. Robert and had successfully re-told the Chiropractic story, passionately, several times.  He was a huge fan of the philosophy, science and art of Chiropractic, and you could tell he would be for life by observing the way these Catholic women held their collective baited breath.  At one point he brought the two of us up to the stage and asked us to speak a few words. 

The line was over a hundred deep to get the first adjustment.

The line was over a hundred deep to get the first adjustment.

Dr. Robert eloquently spoke about how the body is either moving towards a stronger, healthier place each day or a weaker, sick life.  It was clear to me at this moment why Dr. Robert was successful in practice.  He told the story; he told it right, and he spoke with true passion.  I now strive to meet him at his level.  Then it was my turn, and true to form I went to the microphone to get everyone fired up about the experience they were about to have. 

The women in the pews before me broke out in joyous laughter as the first words to come out of my were, “Ete sen” (How are you?) in perfect Ghanaian Tri.  When I pursed my lips and excitedly continued, “Wohotesen” (I am very well),you would have thought I started running around the room lighting off fireworks, because they went bananas.  After a brief introduction about the white dude from America and stated intentions to serve, I told the crowd ‘Medaasi paaaa” (Thank you VERY much).  That was the cherry on the ice cream, because even Father Moses was shocked at how well this “abruni” (white man) spoke Twi.  In Ghana, English is the “official” language, despite the fact that almost none of the locals speak it as their primary tongue.  They prefer one of about 50 tribal dialects, the best known of which is the Twi.  I speak very little Twi, but if you can learn a few basics and lead a conversation with a Twi word or two, any and all cultural barriers are annihilated.  With this simple act, natives immediately understand that you respect Ghana, its people and their culture.  I heart Ghana, and these women knew it.

Notice the that the author is covered head to toe in sweat.  I heart my job.

Notice the that the author is covered head to toe in sweat. I heart my job.

 

The pictures speak much more than words.  Covered head to toe in sweat, energized by the smiles and laughter of these women, Dr. Robert and I positively changed lives for over 200 people in just over an hour.   It was magical.  There were several points in time when the women lining up to meet us started to sound like hens in a coup positioning for the rooster.  But Twi is a very animated language, and dialogue that sounds like a disagreement of epic proportion, may merely be a conversation about what type of corn is best used to pound Fufu (a local soup).  And yes you do “pound” corn and plantains with a 6-foot tall wooden stick to make fufu.

The author helping up a young lady after her 1st adjustment

The author helping up a young lady after her 1st adjustment

After we finished adjusting the masses, we moved to the rectory where a few people would trickle in throughout the day.  For each person we adjusted, we required two things.  1) The each person needed to understand what we were doing here and why.   Thus, either in broken Ghanaian Twi or in broken North American English, a brief test was given so that we knew they fully understood that they were about to receive the first adjustment in a series that ultimately would lead them to a stronger and more healthy life.   2) Each person was required to know that we were not here to correct money for our non-profits or ourselves.  Instead, to complete the cycle of giving, we asked each person to consider making a donation to a school that Father Moses and Robert were building.  The donation we asked for was 2 Ghana Cedis (About $1.50 U.S.); however, if someone could only pay a few cents or nothing at all, that was also acceptable, as we turned nobody away without their power turned on!

Dr. Robert and Dr. Jay adjusting under the watchful eyes of Father Moses and the Virgin Mary.

Dr. Robert and Dr. Jay adjusting under the watchful eyes of Father Moses and the Virgin Mary.

There is one P.S. to this story. The whole time I was sick.  I had the worst case of the stomach flu (aka Montezuma’s Revenge) than I had my entire life. Despite this, it was one of the best days in my life.  Certainly the best day clinically in the short 6 months I’ve been a doctor.   Truly, what I have learned that there are three vital forces that provide nourishment in our lives: 1) a nervous system free of interference 2) the intent to make a positive difference in people’s lives and 3) compassion to serve from the heart.  In combination, these three forces can overcome even the most vengeful case of Montezuma’s Revenge known to mankind.

I am approaching my last fortnight here in Ghana, and am very sad to be leaving.  The people have been nothing short of amazing and I am so grateful for all the support that the J2S team has offered.  Intentions, money and supplies have gone farther than you can imagine.  

Please continue to help us bring wellness and Chiropractic to the world.  The relationship with Ghana and Dr. Robert’s Chiropractic for the World Foundation is far from over.  Our parting words at the airport on Sunday were, “See you back here soon?” With your support that answer is “You betcha!”

Tags: africa, africa chiropractic, Chiropractic, chiropractic mission, chiropractic missions, christina hunter, donation, Ghana, Health, Health mission, jay breitlow, Journey, journey to solidarity, Robert Champagne, Service, Solidarity, volunteer, wellness

Jay on April 28, 2009

Posted to journeytosolidarity.org by Jay Breitlow.  Photos courtesy of the Author.

The Author with the 3 children of the Ashanti Chief.  Always present is the Black Star pride. Note that the boy in Blue will succeed the chief some day and is thus called "Nana"

The Author with the 3 children of the Ashanti Chief. Always present is the Black Star pride. Note that the boy in Blue will succeed the chief some day and is therefore called Nana.

This weekend I had the pleasure of visiting a small village north of Cape Coast.   Heading westward out of the smog and traffic of Accra, one cannot help but marvel at the natural beauty of the African landscape.  The dawn sun peeks though high thin clouds and begins to warm the crisp morning air.  A cool sea breeze, fresh with the scent of salt, enters the windows, tugging and ripping playfully at my shirt and standard issue blue bandana.   Rising above a clearing I’m afforded a view of a valley, The lush green forest is dotted orange with small mud-hut villages that teem with early morning fires burning dry palm fronds.  A bit further along the road, between head bobbing naps, the mind is left with an unmistakable African impression as giant Kufu trees in the distance reach impressively for the sun, yearning to stake their claim to the bright sunrays, with which Southern Ghana is so blessed.  Offsetting this is the screeching bus horn and the feel of plastic covered coach chairs.  Years of human sweat and dirt has piled up on these “protective” covers, and I am left wondering what strain of E.Coli is attaching it self to my shirt?

Baboons on the road?  Yep welcome to Africa!

Baboons on the road? Yep welcome to Africa!

After safely navigating the plastic covers, which would be better used for your son or daughter’s Petri dish experiment in Science class this week, Dr. Hunter and I arrive in Cape Coast.  Our mission today is to deliver a sizeable donation to the future chief of a small village, so they can improve their “school”.  The “school,” in all actuality, is a dusty clearing under a tree in which about 50 hard wooden chairs are placed in front of a rickety blackboard clamoring for retirement.  

Many of the children there have never seen a spiral bound notebook, and none have seen colored paper or colored pencils.  That all changed this week thanks to YOUR generosity and the determination of one very special individual.  This person is Angie Gibson, and she is a pre-school friend who, like me, also grew up suffering cold Wisconsin winters and long sweaty summer nights.  

This is Butre, a typical African village.  This one was further South then the one we took the supplies to.

This is Butre, a typical African village. This one was further South then the one we took the supplies to.

 Similar to so many of you, Angie is a philanthropist and a ‘lovemarker’ (as Ghanaians call loving/giving people).  Angie took matters into her own hands to make a difference by initially making a financial contribution; however, Angie decided that she desperately wanted to do more. Several emails back and forth, we devised a plan to have materials brought to Ghana through a friend of Dr. Hunters, Chauncia, who lives in Tampa.  Since Chauncia was coming via plane and going to be weight restricted with her luggage, I wasn’t sure exactly what was going to show up on arrival.  I was blown away to find that from Wisconsin, to Ghana via Chauncia in Tampa, Angie has sent the following: 30+ notebooks, 150+ pencils, 200 pieces of construction paper, 160 erasers, 50 colored pencils and a dozen pencil sharpeners.

Myself and Dr Hunter with Nanna Boute.  A part of the donation can be seen in the foreground on the table.

Myself and Dr Hunter with Nanna Boute. A part of the donation can be seen in the foreground on the table.

My job was easy.  All I had to do was fill suitcases with the supplies, jump on a bus, and accept the Chief’s gratitude.  Score!  The chief and his family were overwhelmed with joy and promised that this donation would make a huge impact on the future of the children in the Ashanti Region. 

The Chief promised to make the 6-hour drive further north within a fortnight.  We would have loved to make the journey all the way to the village just to see the children playing excitedly with their new treasures.  However, driving nearly 24 hours within a 56 hour weekend window was just not appealing, especially given that we both needed to get back to Accra to begin adjusting patients on Monday morning.

From the bottom of our hearts at J2S to you all: “Thank you” for enabling positive change in Ghana and throughout the world.  I am sad that my time here is quickly drawing to an end; however, I know that there is much work to be done back in the States and in settling into a new location.  As the situation in Madagascar continues to be best described as “unstable and dangerous,” we are looking at other areas of need around the world and at home.  We are looking for contacts that may provide us with the opportunity to serve for extended periods of time.  If you have thoughts or ideas please email any of the Board of Directors as all input is greatly appreciated.

Tags: africa, africa chiropractic, angie gibson, Chiropractic, chiropractic mission, chiropractic missions, christina hunter, donation, Ghana, Health, jay breitlow, Journey, journey to solidarity, Service, Solidarity, volunteer

Jay on April 18, 2009

Photos and story posted to journeytosolidarity.org by Jay Breitlow.

The first week in Ghana I had a very difficult time remembering all the Ghanaian names and the unique personalities that went with them. One man, Kweku, seemed different and from the start we have had a bond that allowed the two of us to get along swimmingly.

The infectious smile of Uncle Kweku

The infectious smile of Uncle Kweku

Kweku is a 75 year old retired man, who comes to see me two or three times a week. His salt and pepper gray hair swiftly receding from his brow reflects his age. His dimples that swell when he flashes his ear-to-ear schoolboy grin, sets him back decades in a sort of youth restorative time capsule. His walking cane, however, brings your attention right back to the fact that this man’s body has weathered the storms of life, despite the age defying spirit that infuses any room he enters.

The ‘Cane story’ goes back over 100 years in Chiropractic, to a generation when the ‘Developer of Chiropractic’ Dr. BJ Palmer was in his prime. You see back in the early 1900’s when the profession was merely in it’s infancy, people didn’t know about the miracles of a nervous system free of interference. When people started getting positive results without surgery or drugs, stories started to become larger than life. With respect to canes; people were getting positive results eerily fast from the care of Dr. Palmer.  In fact when they walked in with canes, the story goes, they became so excited when they left ‘cured’ that the once needed canes were often left at the door. A bit far fetched to have such a fast and quick turnaround, but not totally out of the realm of possibility, at least for a few folks. What is most likely closer to the truth, is that BJ had a fetish for collecting strange canes of the world and when patients were getting better after repeated treatment, they would leave their canes in token gratitude to add to the collection. You get the idea…

This story is not all that different, despite my current cane collection being at zero, it will hopefully not be long until I have the first one. ‘Uncle’ Kweku has been walking and standing with the assistance of a cane since he had an accident about 5 years ago. As he recovered from the fall he began walking and standing with the aid of a cane. Time passes and the body adapts, and Kweku’s body got used to the idea of the cane. Subsequently the left knee never healed correctly and the cane became an extension of him. When we first met, he had a noticeable limp to the right side (the same as the cane in hand) and could not get up any stairs without considerable effort and/or help from his son. Chiropractic was new to him, although before I had arrived he had a few adjustments from a young doctor in Accra who was adjusting with an instrument. His results were generally positive from a spinal standpoint; however, the knee was not recovering swiftly as the practitioner was focused solely on the spine.

Working on Kweku's knee, after about three weeks from initial presentation.

Working on Kweku

When I examined him I found nothing of significance spinally except that he (like the rest of us) was subluxated in the pelvis and mid lumbar region. The right knee was in pretty good shape and strong for a man of his age. This was no surprise to me as most Ghanaians of age are grizzled and tough. The left knee, which was the effected knee, had become fibrotic. The fibrous tissue meant that his muscles and ligaments surrounding the knee were becoming taught. This is the body’s way of protection, when something is hurt it knows that the safest thing to do is to surround and immobilize. This is great for healing, however this veteran was in need of a knee that would once again have his actions as spry and wiry as his personality.

I knew that my job was to immediately begin work to keep removing spinal nervous interference while restoring the joint space and eventually (hopefully) motion. There are two large leg muscles that act in coordination with human locomotion, the quadricepts and the hamstrings. Both of these muscle groups were tight and offered little to no motion when challenged. The joint space had also been locked down and offered much resistance in my efforts to traction the knee. There is a muscle behind the knee called popliteus that is also a major player here. Clinically I adjusted the knee both with an instrument and with standard ‘Palmer Package’ manual adjusting/traction. I also supplemented this care with a focused soft-tissue release system called ‘Active Release Technique’ or ART for short. The ART when combined with the adjustment has proven to be quite powerful. If you have any friends who are Ironman triathletes, they will tell you that their success is tied in knowing a good ART doctor.

After 4 visits in just over one weeks time Uncle Kweku tells me that he has a surprise for me. So he calls me in a very ‘look at me now mom’ manner to where he is standing with his cane. Then he proceeds to stand sans cane. Voila! It was only a few brief seconds, but it was major progress. In my head I was picturing a Monty Python song and dance moment for us, instead an appreciative hug and a photo would do for now. I told Kweku that before I leave I wanted to take this same camera in the same spot with and make a new photo with him NOT using the cane at all.

Uncle Kwiku with the Author.  This was the photo taken right after he stood without the cane for the first time in years.

Uncle Kwiku with the Author. This was the photo taken right after he stood without the cane for the first time in years.

Since that day has passed, I have seen Keweku 9 more times over the course of a month. I am please to report that he can now walk from the adjusting table to the cane (about 15 feet) and stand for a few brief minutes without support. The cane is still very necessary, but this is real tangible progress. His knee has about twice as much motion as before and the muscles around the knee are stronger and more limber than previous. Kweku is not yet chasing his grandboys around the backyard, yet I remain confident that through your generosity we will soon have a photo of him with the cane laid deftly on the floor.

Tags: active release technique, ART, Chiropractic, chiropractic mission, chiropractic missions, chiropractic travel, compassion, culture Ghana, Ghana, Health, knee, Service, travel

Jay on April 6, 2009

Posted to Journeytosolidarity.org by Jay Breitlow.  Photos by the author.

Harriet is a 19-year-old woman who walks through the room and immediately demands your attention.  I wish I could tell you that it was her beaming personality or her ‘I can stop traffic’ good looks that turns heads.  Instead, Harriet draws stares and strange looks because she is a little person.  Even worse (culturally speaking), she is a little person living in Africa.  Living in Africa as a little person is analogous to being a New York Yankee Fan in Downtown Boston, or perhaps walking down the street holding hands with a Rhino. It just doesn’t happen, and when it does you wonder (sometimes aloud) ‘What is wrong with that person?’  

This is a photo of Harriet.  Taken two weeks after her first adjustment

This is a photo of Harriet. Taken two weeks after her first adjustment

Sadly in cases like Harriet’s, as with most people who are born here with a physical disability, Ghanaian culture tends to throw the blame on bad spirits or something that was done previously by the family.   The disabled in Ghana have been known to be poisoned or straightaway executed by their own families because of the way they were born.  Shocking!  What is just as shocking is the common practice of hiding the disabled in rooms where others can never see them.  To the family’s credit, they loved and cared for her, although she was clearly treated more of an outcast than the other siblings. 

 When I looked over the history intake form, the family was particularly concerned with ‘why are her breasts so small?’ and under reason for injury was written ‘Spirits.’ I also discovered that she wasn’t eating more than a few small snacks for meals that were sprinkled randomly around the week.  This was also bothersome to the family, but when we chatted, the father had no beef about changing the topic and asked with no hesitation ‘why are her breasts so small?’  It was one of those moments when you can see things flashing in slow motion.  As the father was starting the sentence, I knew where it was going and what the reaction was going to be. All the while in my head, I was performing a superman like dive across the table, to put my hand over his mouth.  Of course I just sat there professionally and took notes and sadly watched as Harriet slunk even further into her chair, chin now resolutely tucked to her sternum and her eyes focused on an arbitrary speck of dust on the floor.  The chances of her getting married in Ghana were slim, and she is fully aware that is a chapter out of ‘bad news bears.’ Culturally women here place great emphasis on getting married, especially since they live at home until a man comes and sweeps them away.  

As a student, you read about these ‘cases’ and study for tests on them, but as a real life doctor I have zero work with little people.  What to do?  I stalled.  I did this for two reasons 1) to let my brain play catch-up and 2) to detach myself emotionally from this depressed 19-year-old woman who looked like a 10 year old girl that (in my head) may have just needed a hug and a ‘it’s OK your family loves you’ talk from a perfect stranger.  As my analytic mind started to rejoin me in reality, I was remembering school lessons that brought me to the conclusion that despite her age, many of her bones and other structures were developmentally eons behind.  Thrusting into her spine would probably be a candidate for bad idea of the year. 

Shifting back into real-life doctor mode, I told the family that I would like an X-ray of her spine and that ‘yes I think I can help.’  However, I needed to be clear that they should not expect to find any major ‘endowments’ (so to speak) anytime soon, nor should they expect to see any major developmental changes.  Instead, they needed to understand that sometimes things like this happen.  I also mentioned that I didn’t think it was anything they or anyone else did to cause this condition. I did NOT begin to talk about the spiritual aspect for fear that this may have stated a ritual of some sort that needed to be performed just before every adjustment.   Even worse something like a voodoo-doll being brought into the picture what not out of the realm of possibility.

Harriet, her father and the author.

Harriet, her father and the author.

I studied Harriet’s spine the first time with standard Palmer package style checks; including leg length changes, skin correlations, muscle tension, and motion/static palpation.  I wasn’t sure really what to expect, but I adjusted her with a low force precision instrument just as we were taught in school.  To go on a bit of a tangent: The idea that we as Chiropractors are just back crackers or bone movers is to leave a tremendous amount of potential unaccounted for.  There is so much more that we can do, and in lieu of I wish to offer that first and foremost we are nervous system doctors.  Even if I had a narrow definition of Chiropractic before I came to Ghana, Harriet alone would have blown my doors off into next week.  Here’s Why. I immediately started to see changes by the end of the second visit.  Harriet first of all started eating better.  By the third visit she relapsed a little, but now after two weeks of care, is holding her head high, talking for the first time to strangers, eating regular meals with her family and feeling altogether much happier. 

She still is clearly the odd person out in the family, but it’s truly amazing to see how she now interacts with the staff, and with the other patients who come by the office.  In the photo, you can see Harriet wearing a blue bandana, much like the author can be seen sporting around town.  When I told her this, it was as if she was given an early birthday present.  Now I keep one blue bandana in the office just incase my favorite blue bandana wearing woman strolls in.

Clinically speaking (if you don’t want the clinical stuff skip this paragraph), Harriet has not been diagnosed with anything by a medical doctor and without being a specialist I am left guessing that she has dwarfism or Morquio’s syndrome (which I believe is a slightly more serious version of Dwarphism).  Either way, both involve skeletal achondroplasia, which leads to the short stature.  The cervical AP-open mouth and lateral X-ray both showed evidence of Atlanto-axial instability due to a hypoplastic odontoid on C2 and a somewhat associated agenesis of the C1 posterior arch.  Cervical vertebral bodies were all diminished in height.  Although I am awaiting the remainder of the full spine images, I expect to find these bullet shaped vertebrae throughout the spine.  Her muscle tone is diminished and despite a depressive mood, her mental development is on par for that of a 19-year-old female.  

Local family in the central region.  Note the shy girl in the corner.

Local family in the central region. Note the shy girl in the corner.

With merely three weeks of the light force Chiropractic instrument adjustments the changes have included the following: increased appetite, increased sleeping time at the night, decrease in urination frequency (despite the increase in foods and fluids).  No changes noted developmentally.  Emotionally there is marked improvement with her mood with respect to extroverted conversation.  Her posture is improved, and although a biomechanical change may play some part, I suspect this is due more to her improved mood.  For the first time, today her father told me that, she is now sleeping through the night.

I will have more on Harriet before I leave, but wanted to share some of the good news that all of you are making possible.  I hope you have enjoyed the photos and please do find us as a ‘Cause’ on facebook by clicking here.  In love, light and gratitude…

Tags: Chiropractic, chiropractic mission, Ghana, journey to solidarity, Service, wellness

Jay on March 30, 2009

Anabelle being adusted

Anabelle being adjusted

Posted with photos to journeytosolidarity.org by Jay Breitlow

This quick post today is a testament to how quickly children can get better with regular Chiropractic care. Annabelle is a 2-year old child with cerebral palsy. She has very little motor control and developmentally, she is eons behind other children her age. I don’t claim that chiropractic can cure CP, however by unleashing the innate of the nervous system she and her parents can certainly have a more enjoyable and fulfilling life. The mother, Sophie is a wonderful woman with a unique zest for life and is always beaming her infectious smile. When Annabelle first presented, she was rarely smiling, was not interacting with people, nor was she eating or sleeping well. Her exam results were unremarkable and within normal limitations given her developmental constrictions (little to no trunk or neck control and soft bone density). With children I do not claim to be an expert, however thanks to a brief stop in Omaha I learned a few ‘tricks’ from a tremendous doctor (Dr. Jerusha) who sees oodles of children. Given that much of my previous experience was with adults and athletes, I am grateful for my time spent with so many loving families in Omaha along with the tutelage I received.

Sophie, Dr Jay (looking hot and sunburned) and Annabelle

Sophie, Dr Jay (looking hot and sunburned) and Annabelle

Dr.Jerusha tutored me through the most essential areas to pay attention, 1) Atlas/C1 2) Clavicles and sternum 3) Illio-cecal valve. For those who are not medical pros reading this, the illio-cecal valve is a small muscle/sphincter that separates the small and large intestine. It acts as a one-way check valve for our food to pass into the large intestine for further processing. The proper function of this valve is to open and close upon demand. When this muscle is ‘stuck’ open or closed it can cause a backwash from the large intestine into the small intestine, consequently allowing fecal matter to be bound up. It can even go as far as causing toxicity in the local blood supply. Conversely problems with eliminating waste must also be considered. This muscle, especially in children, can also dictate how much or little they eat.

With Annabelle, she needed all three adjusted and I did so in succeeding days. After a four-day weekend Annabelle and her mom came back and when I asked her how she was doing, Sophie said that not only was she eating and sleeping better, but also her congestion had subsided (a symptom I had overlooked at the time).

Wrapping the baby carrier

Wrapping the baby carrier

Sure a good nights sleep will kill the worst of colds, but to get to that point she needed to be first eating and eliminating waste more efficiently. I am confident that the atlas adjustment relieved the sympathetic nervous system, which in turn allowed for the rest and relation of the parasympathetics to take over. With the iliocecal valve adjusted she began eating and eliminating waste normally.

I have since seen her 5 times and she continues to show marked improvement. I am optimistic that she will begin to regain some of her motor patterns, despite evidence that spells out no cure for CP. At this point just sitting upright would be a major bonus.

Anabelle snugs neatly into her Mom (Sophies) reverse joey pouch

Anabelle snugs neatly into her Mom (Sophies) reverse joey pouch

On a side note I can’t wait to be a dad. Why? Well the one of the biggest concerns I had over being a dad was multitasking. In Ghana though that problem is solved. In fact, I even saw a woman in the fishing village pulling fishing nets with both arms while holding her baby. How? Only through the magic of the Ghanaian baby sling. Taking a 6-foot by 2 piece of cloth and wrapping it around the mother while the baby is on the back, you can make this nifty little sling. The child is strapped in better than most of the fancy seat belts back home in the states, and the mom, well she’s free to play cards, eat, or even fish for dinner. (I see no men doing it here, but that’s a cultural thing, and I’m not concerned about that stuff back home, I’m not afraid). Major side bonuses is that 1) the child is usually passed out and sleeping in this reverse joey’s pouch and 2) since the baby is close to the mother for many more hours in the day, the baby develops a stronger bond with the mother.

3) Lastly the development due to mother’s warmth and the position on the back is accelerated versus other babies that are not slung. Note that I have no proof of this, it’s pretty much just accepted anecdotally here, and from what I see there is no mistake of the mother-daughter bond.

There are other success stories coming out of the outreach clinic here in Ghana and I will have the next story ASAP. Thank you for helping to make Annabelle Sophie and many other Ghanaians lives more optimal and enjoyable.

Tags: Chiropractic, clinical, Ghana, iliocecal valve, jay breitlow, journey to solidarity, Service

Jay on March 23, 2009

Published to journeytosolidarity.org by Jay Breitlow.  Photos courtesy of the author.

From a pale Midwest American guy’s perspective I have observed Ghana to be truly an amazing place.  One month of observations (according to Breitlow) and this is subject to change with interpretation.  So with out further ado, Ghana is…

-A woman leaving the shopping mall, pushing the cart with one hand and drinking from a can of Heineken in the other.

Sunlight changes to monsoon in the blink of an eye with this ominous sign

Sunlight changes to monsoon in the blink of an eye with this ominous sign

- always 95 degrees Fahrenheit and hot and humid in the shade, everyday; unless the sky is open and dropping monsoon-like rains (then it drops to 85) 

 

-never a wonderful place to drive, unless you can maneuver an endless supply of potholes with a car that feels like you are driving a shopping cart backwards with a water cannon strapped to the bumper while you wonder if  the people around you are lunatics.

-where you go out to eat and expect to wait 30 minutes for your order to be taken, one hour for the preparation and another 30 minutes for you to receive the check… if you are lucky

Backyard hibiscus flower.

Backyard hibiscus flower.

- colorful.  From the flowers that make your olfactory glands happy to the beautiful traditional African clothing to the bright uniforms of the school children.  The hibiscus flowers here are also used to made a tasty TASTY juice!

-a place where stoplights are optional, but eating with your right hand, and only your right hand is not optional.  Pass the salt with your left hand and you just insulted the whole table.

-where a white boy goes running with his shirt off and everyone from the Army soldiers to the ladies selling fruit giggle and yell ‘obroni!!’ (Twi for white man).  The correct response back is a smile and ‘obibini ete sen’ (Twi for hello black man, what’s up?)

- a culture that burns rubbish on the side of the road, so yes it is normal to see fires on the street and no my house was not on fire lastnight.

In the middle of a downpour, this man is wearing his sunday whites (neck to toe white).  How amazing is it that his stand is in the middle of a red stream of mud and the sugar cane costs 10 cents a stick.  I gave him a dollar and he rewarded me with the photo : )

In the middle of a downpour, this man is wearing his sunday whites (neck to toe white). How amazing is it that his stand is in the middle of a red stream of mud and the sugar cane costs 10 cents a stick. I gave him a dollar and he rewarded me with the photo

 - very Christian.  Sunday roads are nearly always devoid of traffic, but filled with church goers in their Sunday best (see photo to the left)

Doctor Kwabena with Fracis and his 'traditional board'

Doctor Kwabena with Francis (a local Ghanaian) and his "Traditional Surf Board"

 

bizarre by Western standards when it comes to funerals for people over 70.  The services are always on Saturday (but he wake is Thursday and Friday all day) and everyone treats the service as a celebration of the person’s life and not as a melancholic event.  Under 70 and it’s the opposite and everyone dresses in Dark Red and black.

-is great for surfing with a ‘traditional Ghanian surf board’ (See photo below and to the right)

-where the hot peppers are grown by the devil himself out of spite for the human GI tract.

-protected by police that do not take ‘bribes’, but often require you to buy them a tea or a water before you can pass checkpoints. 

-Regardless of where and how you live, you put your best foot forward.  That means that Sundays require you to dress up in your best clothes for church, and that the remaining work days the locals sweep their front porches with palm fronds. 

-Wonderful.

Published to journeytosolidarity.org by Jay Kwabena Breitlow. 

Driving West out of Accra is not what many would call easy, nor something for the faint of heart.  To picture the scene, imagine that you are 5 years old and you have all your matchbox cars out and lined up for inspection in a nice neat line.  

A sunday paddle on Lake Volta in Eastern Ghana

A sunday paddle on Lake Volta in Eastern Ghana

Remember how some were shiny new and a variety of others had paint chips out and there were dings and dents in the metal from repeated use?  Now take your arms around all the cars pull them all together in seemingly random order and you have a Friday afternoon drive in Accra.  Big trucks, small cars, cabbys with nothing to lose, the phat 4X4 Benz SUV, and yes goats and the occasional monkey just for good measure.  Compounding the situation is the fact that just off the side of the road there are smaller dirt roads and vendors selling everything from pineapples and ice cream to Irons, Blenders and flip-flops.  Were you hoping for the 3rd season of ‘Lost’ for $2?  Yep they go that too.  Some guy even showed us that he had porn available to complete the buying experience.  Several of these stands send ‘runners’ out into traffic with their goods trying to bring you front door service.  I admit it, I love it when a little boy brings ice cream in a bag to the door and another brings prepaid phone cards.  Clearly two items not needed until they were presented, and bless their heart for bringing us the tasty morsel among the choking smog and 95 degree heat.  Not sure what my $0.25 will buy them, but I know they will find a way to put it to good use.  Perhaps the most impressive feat of all is the woman balancing an entire trees harvest of plantains on her head while dodging this shark feeding frenzy of a market. 

                        The biggest problem with driving in Ghana is not actually the seemingly chaotic use of space and vehicle.  The problem is that signs that generally point you in the right direction, don’t’ how you say…. exist.  Instead what happens is you drive down the road and if you are going the wrong way people yell in broken English ‘WRONG WAY!’  Likewise if you were to ask someone for directions they give you directions to their buddy down the street, who then gives you directions to another friend or perhaps you have now made enough progress to find the roundabout or hotel you were looking for.  Not that you even are guaranteed to take the right turn out of the roundabout.  In fact I have a rule about all roundabouts in Ghana: ‘If you are not 105% sure which turn is correctly pointing you to your destination, you take at least two trips around, al la Clark Griswold when he was in London looking at Big Ben.  Sometimes I take a good five turns just for Pete’s sake.  

Another real danger with driving in Ghana is when there is no sun left to burn in the sky.  Most countries require lights for driving, in Ghana is seems that bright headlights are optional, and to the opposite end of the spectrum if you want to have a one million candlelight torch as your set of low beams, then please feel free to shine those things directly into my rearview mirror, where I will remain blinded until sometime next week.  Did you think that you had difficulties previously with the sparse signage?  Prepare for nil on the signage folks, because there is just no way as illumination on the road isn’t there.  There are some advantage though to growing up in an area where ice and snow line the ground for over half the year, enter the rain.  When it rains in Ghana people hibernate.  What was a once bustling street with vendors and cars is now either devoid of traffic and people or else pulled off to the side.  Those who do brave the rain do slowly with a very meticulous nature.  All of a sudden stoplights seem to exist and where people were once oblivious to the suggestion of a speed limit, they are now a good 30-40 km/hr under the speed limit.  But not this guy!  I’m used to rain, sleet, ice and snow and now I’m the crazy Ghanaian driver and people look at me like I’m on a mission to meet my maker.  Alas I live to write about the tale, albeit Ghana won this round again because I missed my turn and had to drive an additional 45 minutes to find a proper turnaround.  

Ghana is a very safe African country and largely because there are good police officers here.  In fact I see about 6-8 on a regular basis in the clinic.  Most if not all of them are very nice and well intentioned, however there is always the exception to the rule.  Last weekend when we drove to the Eastern part of Ghana we had the pleasure to meet Ghana’s finest boys in blue.  The men (and women, because Ghana is very much equal opportunity) are set up about ever 20 km with a policed checkpoint.  What are they checking exactly remains a mystery to me, but that is not the point here.  Assuming they are checking for proper identification and proof of registration would be one guess because that is what is usually looked at when we stop.  The thing is that on most occasions they are looking for an opportunity to make a few extra bucks.  Take these two examples.  The first is the normal ‘tea bribe’ and you know that when you are stopped and the officer is overly friendly that you are going to be expected to pay the ‘tea tax’.  ‘Hello office how are you tonight, everything well?’ Yes, yes sir it is wonderful.  ‘Tell me where are you going tonight?’  Insert idle chit chat here and then: ‘So do you have your registration and license with you tonight?’  ‘Well yes auntie I do would you like to see it?’  ‘How about instead you just buy me a tea?’ or the always friendly ‘How would you like to buy me a water tonight to keep me cool?’  To which I always respond friendly and smiling ‘For Ghana’s finest?  Well as long as the tea is hot or the water is cold I would love to!’  The customary handling over of two Ghana Cedis  follows($1.50 US) and you are off.

                        Occasionally there is the attempt to price gouge you though.  You have to understand that many of thee people are collegiately educated and paid a salary of $100 a month, sometimes less!  What they see is a white person in a car and they know straight away that we are likely to be more financially secure then they are.  They also assume that we are travelling on a holiday, which in most cases is indeed correct.  Of course this is not true for me.  I am a volunteer doctor working in their country giving up my time and money to make their country a better place.  The coolest part is that even the gougers understand this as illustrated in my second story. As a side note and prelude to this story is that I’m told that in neighboring countries like Togo and Benin is that checkpoints and the hassles at them are 10 times as frequent and twice as expensive Ahhhh!!

Children selling oranges. Notice the disparity between economic classes as evidenced by background autos.

Children selling oranges. Notice the disparity between economic classes as evidenced by background autos.

Nearly the whole way home I pull off at another police checkpoint.  This time the officer asks me to get out of the car after he checks my license.  My heart begins to race, this is not good.  He looks very solemn and concerned, not because of my destination (Accra) or my license, instead he is concerned that one of my bulbs in the taillight is burned out.  ‘You see this is a violation in Ghana to drive without your bulbs correctly installed.  I am going to arrest you.’  Oh geeze if this was really the case then 99% of the people on the road would be pulled over.  I’m clearly being targeted for a bribe.  My heart rate continues to climb and I am becoming uneasy as I wonder if I will see the inside of a Ghanaian jail today for a burned lout 4 Watt light bulb.  Before I can even start to ask about where to have it repaired or what the fine is he asks me ‘Why are you in Ghana?’  The honest response was ‘Well sir I am a doctor and I am volunteering my time in Accra at a clinic there.’  No response.  Instead he turns his back to me, drops his head and hands back my license.  A flick of the wrist, a look at his buddies dejectedly and the word ‘Go’ was my ticket out of there.  He understood that he was witness to someone who was here of his own choosing, to help his people and to redistribute the wealth of the world, and could not in good conscious rub that the wrong way. 

I’m not at all bitter about this system; in fact I just smile internally because they get it.  I get that they are underpaid and protecting the country, keeping it safe for people like me to visit.  Perhaps if there was a better understanding of this in other countries, like Madagascar, I would be there volunteering.  Instead I am in Ghana.  Wonderful Ghana.  Please continue to help me to redistribute some of our good fortunes here and make the world a better place where social solidarity and peace live each and everyday.

 Pictures courtesy of the author and available via email for distribution with permission.

Tags: Chiropractic, Ghana, Journey, journey to solidarity, Service, Solidarity

Jay on March 11, 2009

Northeast Ghana, nearly into Togo.  Posted to Journey to Solidarity by Jay Breitlow

Driving for 4 nearly five hours north and east out of Accra we found ourselves in what has become ‘normal yet unusual’ African territory.  By this I mean that after two weeks of living in the city we’re been accustomed to seeing Africa as a large city, filled with people, cellphones, rubbish and smog.  On our way

Mud huts in the East Volta Region

Mud huts in the East Volta Region

to the north east highlands, we first pass a cess-pool of a city called Tema with trash and refuse piled as high and wide as the eye can see.  Buses and large trucks belch dark plumes of soot into the sky.  It’s not 10 miles or so away from this city and away from the Accra coast, when we start to notice that the air breathes cleaner, the rubbish becomes less and the foliage starts to come though en force.  Soon we are seeing more ‘familiar’ frames of Africa.  Giant trees, grass, villages made of mud huts and country pride.  The type of cultural Africa you are used to seeing on National Geographic not on page four of the newspaper. 

Purchasing a local music instrument by the side of the road.

Purchasing a local music instrument by the side of the road.

Today is Ghana’s Independence Day and as the day moves alone we begin to pass more villages, each which is celebrating with vibrant pomp and circumstance.  Plastic chairs are laid out underneath giant Bako Trees to seat the entire village comfortably in the shade while school children are beginning to assemble as the band organizes it’s music for the ceremonies.  To the sound of a four or five person brass and drum band the children March around, dance or act out scenes of Independence while the elders look on fondly remembering the times they had to perform the same familiar scenes.  The children each are wearing a different color uniform depending on which classroom they are enrolled in, forming a cornucopia of vibrant purple, orange, blue white, black and green colors. 

The author with Dr. Christina and Raphael at Wli Falls

The author with Dr. Christina and Raphael at Wli Falls

Our destination location today is the stunning waterfall, Wli Falls.  The falls are the highest in Ghana and by all our accounts as beautiful as promised once we navigate a 35 minute flat, albeit mosquito plagued, hike.  We are also rewarded with a shallow 3 foot deep swimming oasis and a refreshing shower of water from the falls above.  The heat and sun in Ghana can be relentless at times and this feels literally like an oasis in the desert.  After spending over an hour playing like school children we are ready to head back to the car when we notice a group of local, mostly Ghanian men approaching.  As soon as they rest to the falls they start to sing and dance.  Instead of describing it, click here to check out the youtube video (or see the video below) Once we re-navigate the jungle we find ourselves in town where the local, well fed children pester us relentlessly for money.  ’Please mister, need money for food and a soccer ball.’ This is a whole different topic, one which I will not get into now: ‘the difference between charity for those in need versus those who hold their hand out searching for and living off of others in expectant charity.’  It’s also a similar battle that many of us face as leaders in our community. 

This is the road less traveled which took us to small villages and areas of need in northeast Ghana.

This is the road less traveled which took us to small villages and areas of need in northeast Ghana.

Driving home the next day we can’t help but notice that which was once a clean celebratory spot, there is now rubbish strewn tornado style.  A reminder that we are humans must keep vigilant to reduce our footprint each and everyday.  These proud villagers will no doubt clean their village centers, but the time and effort necessary begs the question, at what price do we continue to party on this earth until she cannot hold us any further?  At what point do we continue to celebrate our mortal achievements politically and financially at the tangible and karmic expense of our mother Demeter/Earth?

 

Monday is approaching quickly and we are all looking forward to the challenges that lie ahead with the people we will be adjusting in the morning.  I am already seeing people have radical changes in their life from only one or two adjustments.  In particular a man with a walking stick seems to be leaning less on the stick at the end of the week.  I wonder if he will have dropped the stick by the time I leave Ghana.

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