Author: Nanadadzie Ghansah

SSA seems to be the crucible of disease. Most of our modern day epidemics seem to emanate form this area – HIV, Ebola – to mention just two that have had significant mortality.
Disease in SSA is however nothing new. The region has always had numerous infectious and vector-borne diseases.
I seek to argue that the prevalence of disease in SSA might actually have saved the lives of most people in the region.
Now how can I say that when I consider the levels of, say, infant mortality? Or even the loss of life from the Trans-Atlantic Slave Trade?
Lets go back several hundred years to about 1490. This is the period when Columbus landed in what is now Central America. He was wowed by what he saw. He returned to Spain resolved to come back to the Americas. This time around however, he was coming back with a rather sinister plan. He was going to kill off the indigenous population and claim the land for Crown and Church. This was sanctioned by both the Church and the Queen. After all those native Americans were nothing but heathens.
The plan went without a glitch and the Spanish and Portuguese took over most of Central and South America and in the process literally exterminated millions of Native Americans.
A similar process took place in North America with the English being the primary perpetrators. At the end stood the indomitable USA among the ashes of millions of Native Americans.

Now, SSA was been “found” around this same time period. It ultimately became a the source of manual labor for the cotton and sugar cane plantations in the so-called New World.
So why didn’t the Europeans exterminate most Africans like they did in the Americas and take over the land?
One argument is that once black Africans were seen as an optimal manual labor force, the wish was not to exterminate them bit to transfer as many of them as possible to the Americas. The transfer process itself was close to being an extermination but the numbers were so great that they got enough people over to the the cotton and sugarcane fields of the Americas.
The other argument, which I tend to favor, is the role of disease and specifically malaria. Malaria, a disease to which most indigenous Africans develop some form of immunity to over time, is devastating for anyone contracting it for the first time. It killed quite a number of European settlers. This dampened any desire for an exploration of the continent. A total extermination of the people of SSA was therefore indirectly prevented. Now the loss of African lives in the form of the slave trade still went on.
However most of these lives were transplanted into live misery to the other side of the Atlantic.
A glimpse of what could have been is seen in South African, a region with a climate and disease profile much kinder to the Europeans settlers.
A true exploration of the continent started in the mid-1800s and this was shortly after quinine was discovered to be a cure for malaria.
And then you saw the true face of European colonization.

For Native Americans and Africans from the sub-saharan region, the discovery of their respective continents by the European explorers of the 15th century has spelled nothing but misery. For most, the misery still continues.
Unlike the Native Americans, most Africans still have control of their lands, even if they are still massively exploited by richer nations and their own corrupt leaders.
Even as disease continues to be a major factor in the lives of most people in SSA, let’s not forget that malaria might have been the one thing that saved us from Columbus-like extermination.

References

1. American Holocaust – the Conquest of the New World – Stannard 1993

2. Encyclopedia of Africa – Appiah & Gates 2010

3. http://www.cdc.gov/malaria/about/history/

From the collection of thoughts around the premise that a leader without a vision is like fufu without soup.

And when the people realized that they were eating their fufu with no soup, he scrambled to give them anything that looked like soup.
“But that us Milo”, they yelled.
“Ew, that tastes like bitters!”
“Is that Fanta?”
His eyes darted back and forth.
“God”, he prayed, “what is this soup they speak of?”
There was silence. It was filled with incredulity. The people were aghast.
He didn’t not only have soup. He didn’t even know what it was. Why was he serving fufu then?

You must be living under a rock if you haven’t heard that Facebook went public last Friday. That is all most media outlets have been reporting for the last week.

Like most retail investors, I thought about getting some Facebook shares but that is all I did – think of it.

It opened at $38 a share. On the surface, that does not look like much but then consider how the share price of a company is reached. The price reflects how much an investor is willing to pay for the share based on the company’s earnings. Take Apple as an example. If Apple distributed all it’s earnings to all it’s shareholders from the last 4 quarters, each shareholder would get approximately $34 per share. Based on this number, investors decide how much they want to pay for Apple’s shares. Someone will say, I want to pay 5 times it’s earnings because I believe the company is growing. Another would say 10x and yet another 15x. This known as the Price-to-Earnings (P/E) ratio. In reality, Apple trades at about 15x earnings giving it a share price in the $500 range. Google also made about $33/share and trades at a PE ratio of about 16. In the world of investing, a P/E ratio of 15 is seen as cheap, making a company like Apple or Google worth a look.

Now let’s look at Facebook. It’s earnings per share for the last 4 quarters came to about $0.43 a share. At a price of $38, you are giving Facebook a P/E of about 89! Are you prepared to buy Facebook for 89x how it is earnings? Do you believe in the growth of the company that much?

This made me think of Google, a company seen as a direct competitor of Facebook. No one can deny that Google is making money hand over fist. They developed a good concept to make money out of search and it’s working great. Can Facebook do the same?

Which brings me to my story:

Somewhere in Middle America is a city called Net City. Net City is a booming metropolis with jobs, lots of good schools, great restaurants and growing industries. What it lacked 10 years ago was a way to find where anything or anybody was. The libraries were antiquated and the information centers badly staffed. Two young men, Larry and Sarge, decided to open a library/information/search center in Net City. They called it “Findle”. Soon, Findle was where everyone went to find stuff. All the out-ot-towners stopped there first. It was booming. They had devised a way to charge users of Findle for using the services. Since there was nowhere else to go for information, they held a virtual monopoly. Since most of the businesses realized customers could find them through Findle, they bought advertisement space at Findle. Life was good for Larry and Sarge.

Time went by. Net City grew some more. A young man called Mark opened a club where friends could meet, chat, shoot the breeze, gossip, whatever. He called it “The Hook”. It was unlike anything anyone had opened in Net City. The best thing was that it was free to become a member. Soon, everyone in Net City was a member of the Hook. For all it’s popularity and number of members, unlike Findle, it basically made very little money. As the operations grew, Mark got a smart lady called Cheryl to run the show. She convinced a few businesses to start advertising at the Hook. The problem is, most of the members went there to unwind and had very little interest in the commercials. And when they needed to find something, they went to Findle. If they needed to connect with someone, they went to the Hook.

In the mean time, Larry and Sarge opened a club of their own and called it Findle Plus. They wanted Findle to be not only a place you found things but also a place you could connect with others. It looked like they were going to put the Hook out of business but Mark and Cheryl hung on. The membership increased even more. However Mark and Cheryl realized that unless they could find a way to make money off all those members, the business was not going to grow like Findle. They wondered if they could advertise as aggressively to the Hook members as Findle did to it’s users. They wondered if they shouldn’t charge for membership. they wondered if making any dramatic changes would drive members away.

So how does the story end?

Unless Facebook finds a way to monetize the net experience of it’s 900 million users, I don’t see how the company merits the valuation it has.  Can it do that? I have no clue but then who thought social networking will be such a tour de force these days. Growing the company to 900 million members is no small feat. Monetizing their web experience might be an even bigger feat. If you bet on team Zuckerberg and Sandberg to do it, then $38 is a small price to pay.

On the night of Monday, April 2 2012, the men’s basketball team of the University of Kentucky, the Wildcats, won the 2011-12 NCAA championship. It was the culmination of a season where we saw a team of freshmen, sophomores and a senior, play together as a team to dominate their opponents and win the ultimate prize in college basketball. Since their win, their fans have been ecstatic – it’s been 14 years since the Wildcats won their last basketball trophy. In a state that passionate about basketball, it felt like a century.

Amidst the glee, I hear some voices that speak of the win in disdain. These voices gripe about the fact that John Calipari, the Wildcats coach, is exploiting the “one-and-done” rule set by the NBA.

A little background here. In previous years, kids could go straight from high school to the NBA, totally bypassing college. Examples include Lebron James, Kobe Bryant, Kevin Garnett and Dwight Howard. These are the successful examples. There were some busts too (Kwame Brown). To prevent these kids without much experience from destroying the quality of the product the NBA offered, it was agreed to stipulate a year’s wait between high school and entry into the NBA. So these kids go to college for one year and bolt for the NBA. Academicians argue that these “one-and-doners” are using colleges as a mere stepping stone for getting to the riches of the NBA and neglecting getting an education.  So-called basketball purists point out that even if these kids are talented enough, they are not mature enough for the professional league. They argue that a true college basketball team should be riddled with experienced juniors and seniors.They feel that irrespective of how good one may be, a college player should stay in college till graduation.

The reality of the situation though is that there are kids who are that good and want to enter the NBA straight from high school. They risk loosing a lot of money if their college career is ended by an injury or they do not perform well in their subsequent years in college. The “one-and-done” rule however prevents them from going from high school into the NBA. So, what is the best way out?

That is where John Calipari comes in. This past season, he probably recruited the two best high school players in the country in Anthony Davies and Michael Kidd-Gilchrist. He combined them with another freshman, Marquis Teague, two sophomores in Jones and Lamb, and a senior, Miller,  to create a powerful basketball team. In the process, he taught them teamwork, discipline, patience and working towards a goal. He taught them the principle of the sum of the parts being greater than the individual. He got them to pay defense and share the ball. In less than a year, he sold them a dream and helped them achieve it. He got them to play some amazing basketball.

Now I don’t know about you but I find that to be an amazing feat. I also find it really great that these young men got to be taught these life principles. Who can argue that what they learned in the last seven months will not be beneficial for their professional careers or even life?

We send kids to college to get a degree so they can join the workforce and earn a living. However, does college really prepare our children for life, real life? I dare to say NO! Qualities such as discipline, teamwork and patience are things you are supposed to have learned at home or in high school or somewhere in-between. Colleges spew out men and women who are ill-prepared for the journey called life, irrespective of how many degrees they may hold. Isn’t it then commendable that a coach seeks to imbibe great life qualities in these young men in the little time he has with them?

The “one-and-done” rule is neither good for for the teams which get these kids nor the kids themselves. A two to three year stint in college may be the way to go, and in that I see the frustration of the academicians. Instead of just railing against the situation, maybe colleges should have one year programs for these kids that are geared towards their life as professional basketball players and could include courses on money and time management, public speaking and leadership, the business of sports, ethics, to mention a few. To the so-called purists, note that all we have  is the “one-and-done” rule and I think coaches should do their best to help these kids. Instead of hiding behind the veil of the “purity of the sport”, coaches should think about how best to use the little time they have with these kids to groom them for life. I find it hypocritical to blame Coach  Calipari for making the most out of a bad rule. Instead of seeing it as an exploitation, maybe these purist need to admire what he tries to do for these kids. Maybe they should appreciate the fact that these young men are going into the real world with qualities that may help them deal with their professional careers and life.

I really wonder if any of these purists would complain if Coach Calipari was doing this at their institution and getting them far into the tournament each year.  I wonder if they would complain if their son, who was a possible “one-and-doner” had the chance to be on this Kentucky team. I sincerely doubt it!

Ever since I found out that Kwabena Frimpong-Boateng, a German-trained Cardiothoracic surgeon had returned to Ghana and founded a cardiothoracic center at Korle-Bu in the 90’s, I have been intrigued. You see, I am what some people describe as a Cardiothoracic Anesthesiologist – I put patients who need heart surgery to sleep so people like Dr Frimpong-Boateng can operate on them.

Intrigued because it takes a lot to set up such a center and the upkeep is rather expensive. My dear Ghana is not exactly wealthy and the country has other pressing problems. Even though sub-Saharan Africa has it’s share of heart diseases, especially congenital, I didn’t see the leadership in Ghana backing him.

Intrigued because knowing how Korle-Bu Teaching Hospital is, I doubted if anyone could set up something of that caliber and keep it going.

Intrigued because if I ever decided to go back to Ghana, I may actually have somewhere to practice my craft.

Myself and most Ghanaians looked on unbelievably as Prof Frimpong-Boateng was removed as head of the Center last year by the government, in what most see as retaliation for him showing support for the opposition NPP party. The reason the government gave was his age. The retirement age for public servants in Ghana is 60. He was 61. I would understand if Ghana was crawling with heart surgeons and the dear professor was incapable of operating. Like we all know, there are less than 10 active heart surgeons in Ghana and the professor is NOT senile, demented or has the shakes. He is neither on drugs nor is he an alcoholic. In other words, HE CAN STILL OPERATE!

Anyway, I had always wanted to visit the center and meet the man. Imagine my excitement when a good friend put me in touch me with one of the surgeons who works at the center, Dr Frank Edwin. We talked on the phone and planned to meet when I next visited Ghana.

I was in Ghana these last two weeks and  took Dr Frank Edwin on his offer. I walked into the center one morning not knowing what to expect. I trained in Germany and the US and now work in the US. My active practice involves working with cardiothoracic surgeons more than half the time since 2000. I think I am in the position to say that what Prof Frimpong-Boateng built, without any help from the Ghanaian government is nothing short of amazing.

My plan was to spend only about an hour with Dr Edwin.
We were going to look at possible collaborations.
I ended up staying close to 4 hours.
I spoke with the the other surgeons, cardiologists and anesthesiologists.
There is a dedication that is palpable, contagious and refreshing.
I didn’t get to meet Prof Frimpong-Boateng but I witnessed his work and I was impressed.

The center is no gleaming edifice of glass and steel.
It is rather a bland-looking concrete structure with the bare necessities, run efficiently by men and women with dedication and vision.
There are two operating rooms with all one needs for cardiac, thoracic and vascular procedures.
There is a 6-bed intensive care unit where an anesthesiologist or surgeon is available round the clock.
It is a 17-man team of surgeons, cardiologists and anesthesiologist who care for the patient first and everything else later.
They use old, I mean old, echocardiography machines to capture images.
They take the little they get and MAXIMIZE it – note: MAXIMIZE!
These are highly trained men and women who could earn six-figure salaries in the US making about $2000 a month.

If one man with a vision could get this done without any help for the government in Ghana, what excuse do we have as a nation?
The rooms are clean and organized.
There is not a feeling of apathy and despondence that is pervasive in Korle-Bu.
The doctors order their own supplies, cutting out the bureaucracy and middlemen that is the hallmark of business in Ghana.
The therefore get their supplies when they need them and at much lower prices than the rest of Korle-Bu.
They take care of their equipment and keep them working.
They have a budget they stick to.
They plan for the future.
They are proactive.

To help out patients financially, Prof Frimpong-Boateng started a foundation.
Some patients are brought in, fed for 2 weeks to get them strong enough for surgery, operated on, taken care of postoperatively and even given money for the trip home!
Kidney failure needing dialysis is a possible complication after some heart operations.
When he realized the Renal Unit at Korle-Bu couldn’t help him out, he got his own dialysis unit!

Tetralogy of Fallot, lung cancer, coronary artery disease,  carotid disease, valve diseases? No problem! Bring them over. Chest trauma? One patient in the intensive care unit had survived gun shot wounds to the chest thanks to the center!

All this is due to the vision of one man – Kwabena Frimpong-Boateng.
Did he overreach by wading into politics? – maybe.
However, can you blame him if in his heart he thought he could do more for the nation than the clowns otherwise known as leaders who are riding around in SUVs? – NO!
Was the way he was treated fair?
To answer that, I’ll let every Ghanaian spend a day at the Cardio Center, hear it’s history and let them answer that.
I have my answer.

As I left, I was filled with mixed emotions.
Happy that it is possible.
That as a nation, we can do it.
Sad that when we see someone do it, we don’t even recognize it, appreciate it, emulate it.
Sad that a man could sacrifice so much for his nation and still be cast aside like an old shoe without a word of thanks.

May God bless Ghana with visionaries like him and the ability to appreciate them.

It is the day before Thanksgiving. Manuel, a painter is finishing some work in our home. He told me a story that made this holiday and what it stands for more poignant.

I’ve known him for about 2 years and I know he came into the US illegally about almost 20 years ago. He is here legally now. On the few occassons he’s done some work in our home, he has hinted at how he got into the US. Today, he talks to me about his family, about his kids. He is worried he is making life too easy for them. He worries they’ll grow up “soft”. Then he opens up.

“I ran away from home when I was 12 years old” Manuel said.

I was blown away when Manuel told me that. At 12, I was trying to convince my mum to send me to the best and coolest boarding school in Ghana. Running away from home was the last thing on my mind.

“My dad worked as a farm hand for a wealthy farmer in the small town of Yorito in Honduras. I helped my dad after school and on weekends”, Manuel went on.

Manuel’s dad had 19 children so life was hard at home. Manuel made a few bucks doing the chores of the kids of the wealthy farmer. He also got paid by them to carry their bags to school and to fight for them if they got into trouble. According to him, “those kids never lifted a finger!”

Money was always tight and when it was time for high school, his dad could not afford it. Manuel had heard all these stories about the USA, where one could become someone. He asked his dad if he could move to the US. His dad said “NO!” So he ran away.

Before he did that though, he did his homework. He asked around about how to get to the US. Flying wasn’t an option. He had to hitchhike. He came up with a plan. He would hitchhike to an uncle who lived at the El Salvador border, go through El Salvador to Guatemala to Mexico. Once in Mexico, he’ll find a way to get into the US.

One Friday, while supposedly playing with friends, he took of on his journey. For 2 weeks he walked and begged for rides on trucks. He ate what he could find or steal. He slept in old sheds, under bridges in trees. Finally he got to Mexico, which wasn’t as welcoming as he had thought. He was arrested at the border, strip-searched and dumped back on the Guatemalan side.

“Those Mexican border officials are mean”, recounts Manuel. “They are nothing compared to their American counterparts.”

Not to be deterred, he tried again and made it into Mexico one night. He stayed in Mexico for nine months working and saving $300 in that time. With that money, he was able to pay someone to smuggle him across the border into the US. On the night that was supposed to happen, this smuggler never showed up so Manuel stayed another year working and saving. He decided to do it himself the next time. He found out that if he swam across the Rio Grande river, Texas was at the other side. As long as he stayed away from large groups of other illegals and border posts, he would be fine. So one night, that’s what he did. He swam across the river and crawled out onto land in Texas. Back in Mexico, he found out that he had to walk across the Texas desert to reach the nearest town. He was advised to “follow the towers” to get into a town.

About an hour after getting on land, he was sighted by a border patrol agent who asked him to stop and then gave chase. “I’ve never ran so fast my whole life! When I looked back after a while, he (the agent) was just a speck!” For two weeks, he walked across the Texas desert. He had two water jugs that he filled whenever he found a windmill. He had to drop one as both got heavy to carry as he got more tired. He fed on rabbits and rats he caught.  He had a box of matches with him and cooked them over fire he made with twigs he could collect. “Most times, they were half-cooked!” When he ran out of water, he drank his urine.

A week into his hike on US soil, he came across the dead bodies of a man and a little girl.

“She lay beside him in his arms. She had long brown hair. The birds had eaten their eyes. I wasn’t scared. I just thought about how mean the birds were.”

About 2 weeks after getting into the US, he came into a small town, whose name he cannot remember. He stumbled into a gas station for some water. The owner was really kind. Days later he hitched a ride on a truck to Corpus Christi, Texas.

Four  years after he ran away, he sent his dad $200 with a message that he was alive and well. A month later, he got a letter from his dad. It talked about how worried they had been and feared the worst. It talked about how grandma still cries every night. At the end, the letter read: “I’m glad you are fine now but if I get my hands on you, I’ll kill you!”

Then came Hurricane Mitch in 1998. It devastated Honduras and most of Central America.The US government granted amnesty to Hondurans in the US as a way of helping the country. The thought was the Hondurans here would works and support he rebuilding of their country. Manuel was finally not an illegal immigrant.

Manuel has made a lot of his time here. I got to know him through a builder friend when I needed our deck painted. You see, he is self-employed now as a painter and is doing rather well for himself. He met and married a woman from Mexico who decided a few years ago to move back to Mexico with their 2 children. In 2004, he went back home to Honduras and bought the farm that he and his dad used to work on. “Those kids of the rich farmer never learned the value of work and could not manage the farm!”, Manuel explained. It is for that reason he is worried about his kids.He wants them to learn the value of work. He wishes he could teach them that everyday. He misses them.

“I am really grateful for all I have now looking at what I went through”, he added.

Those words stuck with me. I guess the season made him reflective. Whatever the reason, I thought of my life, what I had gone through to be where I am now and the sacrifices I made and they pale compared to what Manuel and thousands of other illegal immigrants go through to make it to the promised land.The trip from Honduras to Mexico is about 1500 miles and that from the Rio Grande River at the US-Mexico border to Corpus Christi Texas is about 150 miles.

I think of the old Persian saying: “I wept because I had no shoes, until I saw a man who had no feet.”

I think of millions who live in areas torn by war, famine, disease, I think of the sick, of orphans, of those jailed for crimes they never committed, of the oppressed, the abused and I truly count my blessings.

Count your blessings!

Happy Thanksgiving!