They start him off as from Jamaica doing the Jamaican gimmick to get him over(make him a fan favorite) with fans and than later go by his real origin which is Ghana, West Africa. So he is a Ghanaian.

Yes, it is predetermined and the moves are choreographed, but wrestlers do get hurt by accident when a another wrestler work too stiff, land or connect the wrong way, botch a move or whatever...... It does take a tremendous shape to be a wrestler in a ring and they do go to a wrestling boot camp school to learn how to become a wrestler.