Agency in the Decision-Making Process: Amputees Pursuing a Prosthesis in Ghana” Ghana

Ready… Set … Go. I embarked on my journey to a country that has become my second home: Ghana. It was a strange feeling, only having been back the previous summer conducting research. I felt a mix of emotions that I could barely describe, a mixture of excitement, nervousness, and familiarity as if I was visiting my old high school. As I boarded the plane for Ghana, I did not realize how different this summer would be from the previous, and how ultimately I felt more prepared than I really was at the time.

This summer, I researched prosthetics and amputees at the Orthopedic Training Center right outside of Accra, Ghana. It is a non-profit organization that I visited once last summer, and one that helps fit amputees from all over Western Africa for a prosthetic device. It is an organization that helps people without the means to help themselves. I interviewed medical practitioners and amputees in hopes of understanding their decision to get a prosthetic device. Having studied the desirability of a prosthesis in the face of structural and social barriers the summer before, I ended up leaving with more questions than answers. I felt compelled to return to Ghana to better understand amputee care and to collect more data in hopes of doing something more substantial with my research. With this mindset, I returned to Ghana to study the agency of amputees in the decision-making process to see if they have any say in the decision to get a prosthesis – or if it was even their own decision in the first place. This research led me to conduct over 50 in-depth interviews with amputees from across Ghana, extensive ethnographic research at three different care sites, and a comprehensive patient satisfaction survey at one of the sites.

Having left Ghana two months ago, I am beginning to understand that tough questions in social science never have simple answers, and, in truth, just how complex the real world is. I have only begun looking at a field that is oftentimes ignored in academia, but by no means am I leaving with complete confidence in whether amputee care will improve or worsen in the country. What I can derive with complete confidence is that during my time there, I have been able to help improve the lives of some, and that I have left with a better understanding of what it means to live with disabilities in Ghana – a country dubbed by the BBC as the “worst place to be disabled.” I plan on reporting my findings to the organizations I have worked with in hopes of improving their services to their patients, and to share it with other scholars in the field through undergraduate conferences like Notre Dame’s Human Development Conference.

The most challenging aspect that I found about the fieldwork experience was surprisingly not connected to the research at all. Although there were many tough aspects to conducting fieldwork and collecting data, I have found that it was cultural competencies and sensitivities that make or break research projects. As with any field in life, it is sometimes not what you know, but who you know that determines how feasible or enjoyable an experience can be. In my time abroad, I have met some of the kindest people I have ever met in my life. At the same time, I have also faced situations where I felt uncomfortable and even targeted, especially relating to my race. As an Asian-American in Ghana, I was often seen as very foreign - even to the concept of who they would consider as a foreigner from the United States: called “little China man,” the

“konichiwa” greetings, the eye slanting gestures, and the general disbelief that I live or go to school in the US despite my American accent or explaining that I have an American passport. Although these were challenges that made my experience somewhat more uncomfortable at times, it was also an opportunity for me to come face to face with my racial identity in a way that I never had to before in the United States. It was an invitation for me to share a heritage that many Ghanaians have only heard about and to be proud of my identity, very much so in a way that many Ghanaians are proud of theirs as well. During racially charged and turbulent times like now, it is a lesson that was especially relevant and valuable for me beyond my expanding my research skills this summer.

Although there were certainly challenges this summer, one of the most rewarding experiences in my life was tutoring English to the kids at the Centre. To be honest, I was hesitant to tutor them in the beginning because that meant it was going to take time away from the research project. I knew how difficult and time-consuming gathering data can be from last summer, and I did not want to fall behind. Yet now that I think back, I realize what a mistake it was to think that way, and how much I regret thinking that at all. I cannot imagine research without cultural and community engagement, and it would not be my place to write about a country without knowing it or its people in the first place. Spending time with them was amazing in so many ways, not only did it further inform my research of what children with disabilities go through on a daily basis in Ghana, but the kids themselves reminded me of myself when I dreamed about a “normal” childhood when I had crutches due to Legg-Calve-Perthes Disease. This orthopedic condition interrupted blood flow to my hip, which caused it to collapse on itself. My family lacked the finances for treatment, and if it was not for the support of my community, I would have never been able to walk today. It was because of this reason that I wanted to research orthopedics and amputees in the first place, and why I want to practice medicine as a doctor in the developing world one day.

In one particular instance, I went in to tutor the kids on a Friday night, but I quickly realized that we would not be doing homework. Instead, they blasted music in Twi, dancing soulfully to the beat, and embraced the rhythm of life with each step. Being disabled and amputated did not stop the kids from escaping the confines of their wheelchairs, crutches, and devices; they moved as if they had no worries in the world and never endured any hardships at all. I wholeheartedly believe that experiences like these will take them the farthest in life and they are the ones that are the most priceless, when they can interact, enjoy, and laugh in each other’s presence despite their mutual struggles. It is multiple experiences like these that reminded me that a research grant from the Kellogg Institute is so much more than just an academic pursuit, but one that teaches me how to be more fully connected with humanity and witness the depth of the human spirit.

I cannot express how grateful I am for the opportunity to be in Ghana, and how thankful I am for a country that has welcomed me with open arms. The moments of difficulty and laughter have both equally taught me the importance of knowing people who seemingly have nothing in common with myself. As I am now beginning my senior year at Notre Dame, and exploring another chapter of my life as I prepare for my time beyond, I will always remember Ghana to be one of the most formative and rich experiences during my time as an undergraduate. My Kellogg summers in Ghana taught me more than what the world is; it taught me how the world can be when driven by passionate individuals and proved to me that development in practice is necessary and achievable. As I continue this journey towards service, I plan on continuing my education in hopes of becoming an orthopedic surgeon to work on access to rehabilitative devices like prosthetics. I also hope to work abroad to help restructure health care systems as part of the World Health Organization and to one day remove barriers to basic healthcare. My experiences have made me believe that this is achievable and necessary in my lifetime, as long as we take the time to understand the lives of those receiving care and different from ourselves.