August 31th – Back to Accra

Warning: In the post I describe a minor medial issue that other PCVs may get using bicycles – the only independent mode of transportation allowed in Ghana. I'm posting this embarrassing condition in the hope that it will help someone else.

Market Day


The area around Nandom is farming communities with mainly dirt roads. Bumpy dirt roads. The town center and part of a road south to Lawra is paved or partially paved. The roads are dusty or muddy depending on the rain – a reddish brown color that has increased the amount of laundry I'm doing. I have to travel about 3 miles one way to get food. Our market day is Sunday. Each town has a market day and the market women generally travel from town to town. Lawra, a town about 20 miles away has a market on a 6 day schedule.

Market day is the day of the week when you can get the most food. However, in the case of the Upper West Region the selection is rather limited. There are a lot of rice and beans, corn, yams, okra, tomatoes, peanuts, and other things in season. Guinea fowl eggs are also common. Chicken eggs are generally from another region and transported to my area so not generally sold in market. There are limited supplies of bananas, oranges, pineapples, plantains, and other fruits. By limited I mean that I did not see any last week in Nandom – but we may get some from time to time as I saw them in Lawra.

There was almost nothing green in the market unless you count pumpkin and okra leaves. I'll research the best way to cook those to get a more balanced diet. The quality and availability of food will change with the season – right now I'm in a season with a good selection. It will take some planning and adjustments to get use to the menu options.

Bread is always available in town. There are also a few placed in town that serves prepared food.

I'm not going to dive into the local meats yet – although there are plenty options. I'm also told that I can get milk and honey so it is almost like the promised land I suppose. I don't have a fridge and will likely try to make do without one at least for now. So I'll skip the milk until I can figure out yogurt.

My first attempt at cleaning the pebbles from the local rice and beans was not entirely successful. I'm going to have a local teach me how to properly clean them. Eggs and peanut butter (locally known as groundnut paste) will be my primary protein supply for the food I cook myself.

Bicycle riding


I love riding the bicycle. When I was in high school I spent a lot of time on a bicycle and now that I'm in the Upper West that is about the only transportation option I've got to get from my home to market, shops, and other things in Nandom – the other being walking. In Nandom there are a few cars and buses that run between the major towns – Lawra to the south and Hamile to the North. Some people have motorcycles – but neither my mother nor the Peace Corps approves of that option. Still it is interesting to see four adults riding on a motorcycle or watching a brand new (hopefully empty) coffin go by on the back of one.

The bicycle is far and away the most popular mode of transport in my area – the only one many people can afford although many others walk to town from my site. There may be 10 to 20 bicycles for each motorcycle. And there are at least 20 motorcycles for every car or truck on the road. We also have donkey carts – but that is mainly for hauling farm produce. Donkeys are also used for some plowing. Since I arrived in Nandom I've been on the bicycle every day riding 8 to 12 miles a day. A lot of this is visiting people or going into town to get something.

Trip to Accra


The hard seat caused a minor problem for me that required a return trip to Accra. Think hard leather seat and soft American backside – neither one with any significant padding. The rough dirt road caused a bruise that formed into a perianal haematoma. I was in a fair amount of pain and not feeling great so I notified the Peace Corps Medical Office (PCMO) of the situation. The Peace Corps has two doctors on staff and a medical unit in Accra. The PCMO thought a trip back to Accra was a good idea. The idea of another road trip on the overnight bus from Nandom to Accra was the last thing I wanted. But I left the same day.

I had to change buses in a Kumasi around midnight - my wallet must have fallen out of my pocket because when I got to Accra I noticed it was missing. However, I called the station master in Kumasi and he was able to find it. My wallet and all its contents, including the cash, was returned the next day. A testament to the good, honest, hard working people of Ghana.

Back to my embarrassing problem


The PCMO doctor did the initial exam and referred me a doctor at the local hospital the same day I arrived. The hospital was very nice and well equipped. English is the official language in schools so the doctor and nurses were easy to understand and could understand me as well.

After the exam I was taken to the “theater” (operating room) for a small procedure to remove the clot Thursday night. This relieved the swelling and pain immediately. Multiple daily sitz baths for two weeks was the recommended treatment option. This condition is not complex and certainly not serious. It is simply a pain in the butt. The best treatment is to lance the vein to remove the blood before the clot forms. This needs to be done in the first two days. Otherwise one could have the clot removed to faster healing. Otherwise – increasing the circulation – sitz baths – will allow the body to clear itself in about a week. Witch hazel, which is not generally available here, is another common treatment.

By Saturday it was obvious that it had returned so another message to PCMO. I might see the doctor today.  For now the sitz baths are enough.  I'll post a follow-up on my progress when I have more information.


I'm looking for a padded seat for my bicycle to prevent the recurrence. Again – I'm fine – this is a very minor thing that is not serious but, as mentioned, just a pain in the butt.

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