“F
irst
impressions
last a lifetime.”
“Go confidently in
the direction of your dreams.”
These are the words of wisdom
that led me toward my greatest
adventure in medical school — an
international rotation in Ghana.
Pursuing my dream in another
country created memories that
will last a lifetime and inform who
I am as a physician.
First Day in the Labor Ward
As I entered the labor ward at
Komfo Anokye Teaching Hospital,
I discovered a large room divided by
thick concrete walls. Each section
contained pleather beds covered in
plastic tarps that patients brought
from home. I found myself fascinated
by the lack of equipment. There were
no IV poles. The background noise
was free of the familiar beeping
monitors and inflating blood pressure
cuffs. You would not find a large TV
displaying continuous fetal heart
tracings, but on each dividing wall, you
would find a Pinard horn, a funnel-
shaped instrument used to manually
count fetal heartbeats. Intermittently,
I would observe Ghanaian medical
students place their hands on mothers’
abdomens to count the number and
duration of contractions in a 10-minute
period. The results would be entered
into a pantograph, a paper chart that
is used to track labor progression.
Even without the lines and monitors,
it was incredible to witness the level of
medical care being provided within a
limited resource setting.
As I continued my observations, I
discovered that all patients go through
“natural births,” predominantly due to
the cost of epidurals. One might expect
the ward to be filled with yelling
and laboring mothers crying out in
pain, yet it was surprisingly quiet. No
one called out and no one screamed.
Instead, I was surrounded by women
snapping their fingers, praying and
humming through contractions.
As I followed a mother’s progress
through labor, I was taken aback
by her final delivery process. In
the “second stage” area, there is no
coaching, privacy or family members,
just the mother, her midwife and
any medical students who decided
to observe the delivery. Though it
was her first child, the mother was
not coached through her delivery.
If she did not push adequately, the
midwife would hiss in disgust. During
the delivery, the midwife made an
episiotomy, a surgical cut at the base
of her vagina to aid in the delivery, but
the patient, unfortunately, sustained a
second-degree tear. While repairing
the laceration, the patient would
pull away due to pain. Each time the
patient moved, the midwife would
express her anger and displeasure.
I struggled to watch as the patient
writhed in pain. I desperately wanted
to console her, but it did not feel like it
was my place. With each unwanted
movement by the patient, the tension
in the room built. The midwife grew
tired and at times, even pretended
to give up on completing the repair
entirely. Seconds felt like hours as the
midwife worked to close the laceration
and reunite the mother and her baby.
First Day as First Assist
“Can I scrub on your C-section
case?”
“Yes, of course.”
The excitement that overcame me
was palpable, as the idea of being first
assist was merely a dream that I had
prior to visiting Ghana. The resident
took me through the scrubbing
process, which entailed the typical
personal
protective
equipment,
rubber boots and a shin-length rubber
apron worn over our surgical scrubs.
We then scrubbed with pieces of pink
soap left in a dish in the scrub room.
As the foam collected on my hands, I
found myself reviewing the steps of
the operation, the patient’s medical
history and any complications she was
at risk for perioperatively.
As we entered the operating
room, my heart began to race with
anticipation. I gowned and gloved
myself and then assisted with draping.
We then made the first incision of
the elective C-section for a fetus with
a genetic disorder of bone growth
called achondroplasia. When the baby
delivered, his appearance was typical
of achondroplasia: frontal bossing
and shortened upper extremities. The
baby was carefully placed on a nearby
table, and then the surgeon’s technique
took center stage. He prided himself
on minimal tissue manipulation,
leaving the uterus inside the abdomen
during the repair and abstaining
from exploring the uterine cavity for
placental remains. We finished the
operation and the only evidence of
our presence was a small, beautifully
closed pfannenstiel incision.
First Day Eating Ghanaian Fufu
“Are you free for dinner? We are
going to try fufu.”
As a first-generation Nigerian
American, I have consumed plenty of
fufu in my life, including the batches
that I personally struggled to prepare.
Ignoring my familiarity with the
dish, I enthusiastically accepted the
invitation. My mind drifted over the
possible variations of Ghanaian fufu.
Would it be made of potato, yam or
even plantain? Would it be hard or
soft? Sour or neutral? Though fufu,
a staple in Nigerian and Ghanaian
cuisine, is essentially pounded starch
and water, it can be made in numerous
ways. I was excited to try this twist on
a familiar dish.
We left the medical campus and
began our journey to a restaurant
called
Confidence.
When
we
arrived, we each ordered the fufu
with groundnut soup and goat
meat, a standard in Ghanaian
cuisine. Within minutes, the server
placed multiple large bowls of water
and soap on the table and instructed
us to wash our hands. The act
heightened the experience, as I felt
like a native Ghanaian eating in the
proper way. The food came shortly
thereafter, and as the bowl was
placed in front of me I appreciated
the nutty brown color and aroma of
peppers and spices. Immediately, I
reached into the bowl with my right
hand to fish out a piece of the fufu
ball floating in my soap. I flattened
the fufu between my fingers while
simultaneously scooping up the
soup, and then lifting it to my
mouth. The flavors were bold, yet
balanced; new, yet familiar; and
most importantly, delicious.
For
any
student
traveling
abroad, I encourage you to embrace
the unfamiliar. If you challenge
yourself to let down your guard and
experience life in an open, curious
and engaged manner, you will be
rewarded with first impressions
that last a lifetime.
Opinion
The Michigan Daily — michigandaily.com
4 — Tuesday, October 2, 2018
Emma Chang
Ben Charlson
Joel Danilewitz
Samantha Goldstein
Emily Huhman
Tara Jayaram
Jeremy Kaplan
Lucas Maiman
Magdalena Mihaylova
Ellery Rosenzweig
Jason Rowland
Anu Roy-Chaudhury
Alex Satola
Ali Safawi
Ashley Zhang
Sam Weinberger
DAYTON HARE
Managing Editor
420 Maynard St.
Ann Arbor, MI 48109
tothedaily@michigandaily.com
Edited and managed by students at the University of Michigan since 1890.
ALEXA ST. JOHN
Editor in Chief
ANU ROY-CHAUDHURY AND
ASHLEY ZHANG
Editorial Page Editors
Unsigned editorials reflect the official position of the Daily’s Editorial Board.
All other signed articles and illustrations represent solely the views of their authors.
EDITORIAL BOARD MEMBERS
ABBIE BERRINGER | COLUMN
Believe survivors?
I
am a woman. I am a survivor
of sexual assault, but I don’t
want you to simply “believe
me” because I wrote this. Why?
Because I believe in due process.
I believe in “innocent until proven
guilty.” I believe the principles of
the American judicial system are
ones rooted in justice.
I know that the system has flaws
and corruption has overtaken
parts of it. It is hard to come out
about sexual assault for many
reasons. Corruption within the
system often ends up protecting
the
powerful.
However,
just
because we know this is true, it
does not give us the right to label
someone “corrupt” or “guilty”
without the evidence to support it.
It is brave to come forward. I
didn’t come forward. In fact, what
nearly held me back from writing
this piece at all was the fact that I
would have to tell my parents what
happened to me all those years
ago. The knowledge of how much
it would hurt them was almost too
much to bear. Up until now, only
a handful of people knew what
happened to me five years ago
when I was just a junior in high
school. In the days, weeks, months
and even years after the incident,
what kept me from talking to most
people was a mix of complicated
emotions: embarrassment, fear
and an overwhelming desire to
put the whole thing behind me.
If I had gone to my parents, they
would have wanted me to go to
the police. If I had gone to the
police, they would have opened an
investigation. If an investigation
was opened, one thing would
have become abundantly clear:
There was no evidence. It was just
me and him in a dark room, with
one other person who happened
to be asleep. I woke up and he
was touching me, but he didn’t
rape me, so I would have no DNA
evidence. He didn’t bruise me, so
there would be no marks on my
body. There were no witnesses,
just my word against his, and I
know that for good reason the
justice system does not allow
people to be convicted on hearsay.
It is sad. It is sad that I
discovered
that
this
person
committed almost exactly the
same
crime
against
another
friend of mine some time before
this incident had happened to
me. I wasn’t his first victim, and
the sickening truth is that I will
more than likely also not be his
last. Yet the truth is that my word
alone is not, and should not, be
enough to convict him. It doesn’t
matter what the statistics are
on accusations of sexual assault.
Studies quoted in Vox, the BBC
and Vogue have already reported
that most people who come forth
with sexual assault accusations
are not lying. Whether these
studies are accurate or not, I do
not know. However, I do know
that it truly doesn’t matter.
As Voltaire once said, Sir
William Blackstone echoed and
Benjamin Franklin later co-opted:
“it is better 100 guilty Persons
should escape than that one
innocent Person should suffer,”
is a maxim that has been long
and generally approved. I still
believe in this maxim and I think
that, as Americans, we all should.
This maxim is a protection. It
guarantees that someone who
would seek to destroy your life on
baseless accusations, due to some
personal vendetta, or a desire
to harm you for one reason or
another cannot do that without
creating some sort of elaborate
plot that frames you as “guilty
beyond a reasonable doubt.”
The truth is that tomorrow I
could come out with a baseless
claim against anybody, an old
enemy, a bad professor or a former
bully, but I am deterred from doing
so by the fact that my baseless
claim can do no more than hurt
their reputation. What I fear is
that, in this new world, where the
push by the left is to unequivocally
believe the accuser, this deterrence
will exist no more. If we start
punishing the potentially innocent
based on nothing but accusations
alone, then it encourages those
who may seek to destroy someone
else’s life to take that avenue. In the
world of politics, the corrupt work
by trying to ruin the lives of their
opponents. If we don’t want the
corrupt to win, then we can’t give
them the chance to turn allegations
into guilty verdicts, because that is
exactly what they want.
Due to what I have gone
through, it is not lost on me
that this does and will continue
to lead to some of the guilty
going free. It is also not lost on
me that there is still a culture
of mistrust and blatant sexism
toward women, one that has
enabled sexual abuse to continue
running rampant in our society
for far too long. Because of my
own circumstances, I am very
likely to believe the accuser in a
sexual violence case, and more
than anything I want our justice
system to punish rape crimes
more harshly. It is a disgusting
injustice that someone like Brock
Turner, the guilty party in the
infamous rape case at Stanford
University, only spent three
months in prison for his heinous
crime because the judge actually
cared that his life had been
forever changed, as his parents
and lawyers argued in court. His
life should have been ruined. He
didn’t and, in my opinion, still
doesn’t deserve to walk free.
It physically pains me to
think that my abuser walks
free and that there is nothing
even the justice system is able
to do about it, but I know if
my word alone could have
convicted him that would
have been a very dangerous
power. I don’t want that power
in my hands or in the hands of
anyone else. I would rather
see my accuser go free, even
as tears come to my eyes as I
write this, than to know that
the power to ruin someone’s
life based on an accusation
alone has become a reality in
the American justice system.
So, I ask us all to think about
what we should truly believe
in. I believe in justice. I believe
in due process. I believe in
evidence and “guilty beyond a
reasonable doubt,” but I don’t
simply “believe survivors.” It
hurts to say that because I am
one, and most people who say
they are a survivor are telling
the truth, but regardless, you
shouldn’t believe me based on
my word alone.
First impressions
How Trump’s got it wrong on trade
KIKI OGU | WOLVERINES ABROAD
Abbie Berringer can be reached at
abbierbe@umich.edu.
HANNAH MYERS | CONTACT HANNAH AT HSMYERS@UMICH.EDU
W
ith
the
U.S.-
China
trade
war
and
the
sanctions
on Iran and Russia dominating
much of the news these days,
U.S. trade policy has become
the spark of much controversial
debate. To me, this didn’t make
much sense. Any Economics 101
professor would have told you in
the first week of class that trade
benefits all. But when I looked
into it, it seemed that there was
a consensus among some of the
world’s highest-ranked officials
that free trade was not equal to
fair trade. And so, in order to
figure out the truth behind all of
this, I decided to interview one of
our own experts in international
trade: Alan Deardorff, University
of Michigan’s John W. Sweetland
Professor
of
International
Economics and Public Policy.
When it came to the definition
of free trade, the answer was
pretty obvious: in Deardorff’s
words,
“eliminating
barriers
such
that
trade
could
flow
freely.” But fair trade was much
more
ambiguous.
The
term
had begun to be used freely “to
mean any trade (an individual)
didn’t like.” For example, when a
country subsidizes one industry
over
another,
the
industry’s
competitors would view the
trade as largely unfair. But if,
say, China, decided to subsidize
their exports, the U.S. consumer
population would benefit, as
“we’d get cheap stuff.” Similarly,
if a company were to outsource
manufacturing
to
a
country
where labor and input costs were
cheaper, it could also be viewed
as unfair by domestic suppliers.
But, the real question is, if these
allegations of unfairness were
addressed, would trade become
more efficient and less “unfair?”
According to Deardorff, “that
kind of unfair trade benefits us.
Our country overall (would) be
better off if we freely import from
countries that want to sell to us,
regardless of what determined
the prices that they’re offering.”
That said, there is, in fact, a
legal definition of unfair trade.
Economic dumping occurs when
a country exports for a price that
is lower than the selling price
locally. Now, this is controlled
by laws that allow a country
to put tariffs that would offset
the price gap that dumping
creates. But, that said, these
anti-dumping duties are not
often used by the U.S. except for
specific cases in industries such
as steel. Evidently, this “type” of
unfair trade is obviously not what
President Trump is talking about.
Rather,
the
current
administration
has
been
fixated on the tariffs that China
has imposed on us, calling
their acts of protectionism
completely unfair and harmful
to the U.S. Tariffs traditionally
have
two
effects.
One,
they “raise the price to the
(country’s) buyers,” and two,
they “lower the price to the
(country’s) sellers.” As long as
the country is small, the effect
of a tariff is localized and there
is no change in the world price.
However, “when a country
becomes very large, there is the
possibility of pushing down the
exporter’s price.” According
to studies done by Deardorff,
though, “there is no country
(not even the United States)
that has enough share of the
world economy (to significantly
affect the world price).”
That said, tariffs instituted
by countries like China do
have the potential to affect
U.S. producers. But, the extent
to which our producers versus
China’s consumers are getting
hurt by a tariff is mixed.
Obviously, U.S. producers will
lobby for subsidies regardless,
as it is in their political
interest to do so. One popular
case of this recently is the
soybean industry.
With
that
in
mind,
our
administration’s
reaction
in
putting our own tariffs in place
to combat the “inequity” created
by the Chinese tariffs have doubly
hurt our consumers. In fact,
when I asked Deardorff about
this, he said that there actually
is a proper response to countries
that
have
overstepped
their
boundaries by implementing high
tariffs in filing a complaint with
the World Trade Organization.
The WTO would investigate the
measure and determine whether
the tariff is justified or not. In a
perfect world, the United States
should have paused, evaluated
the conflict with China and filed
an appropriate complaint. Rather,
we hastily implemented tariffs
which resulted in an escalation
of the conflict, throwing us into
a trade war. Neither country is
really justified in their actions,
and now the international trade
scene has been turned upside
down.
Trump seems to think that
our trade deficit with China is
the main cause of our conflict.
However, trade deficits by nature
are just a means of a company
dealing
with
specialization.
When a country buys more
than it sells, it’s simply a matter
of specialization and relative
comparative advantage. Though
trade deficits are not ideal in that
we really should be producing for
ourselves, there is no wrongdoing
of China’s that is causing the
imbalance and, according to
economist Joseph Gagnon, “there
is no evidence that high tariffs
reduce (trade deficits).”
The U.S. has unequivocally
got it wrong on trade. We
are sacrificing free trade in
the name of protectionist
policies that are isolating
our country from the rest
of the world and creating
major political and economic
harm. It doesn’t align with
Democratic
or
Republican
policy. It’s just plain wrong.
Adithya Sanjay can be reached at
asanjay@umich.edu.
ADITHYA SANJAY | COLUMN
Kiki Ogu is an M4 at the University
Medical School.