This past week we traveled to Ada to help another organization, Ghana Outlook, construct a school. Similar in its model to GlobeMed, Ghana Outlook is partnered with the Cheshire Fire Cadets from Britain. This year the organization raised over $80,000- quite an amazing feat! Over the span of 18 months the high school (“secondary school”) aged Cadets did every fundraiser imaginable, from climbing the highest peaks in Wales, Britain and Scotland in a 24 hour period to sailing around a lake in a fairy costume.
Surely the physical construction of the school was comparatively simple. Ghana Outlook has built several other schools in Ghana and as a rule the community constructs the roof to establish ownership of each one. However, there was little doubt that the building was a collaborative effort, as women and children of the village showed us how to carry on our heads buckets of the red dirt men dug to be laid as the base of concrete floors. Nationality and organizational affiliation made little difference as we all painted the school yellow and brown and gathered around a bowl of banku and okra soup for lunch. The final product was the largest school Ghana Outlook has ever created.
On the way back home (you can’t spell home without Ho) we stopped at Adaklu, a village where the Cheshire Fire Cadets had built a school previously. Since it was a Sunday, we visited the local church where we were greeted with warm smiles and song. Afterwards we toured the school, which included a computer room and library, and the Cadets donated school supplies and soccer (“football”) equipment.
Our final adventure together was a trek up the massive Mount Adaklu. I’ve seen this mountain every day on my way back from the HOPE Center, but never did I imagine it would be so tricky to climb. What started as a gentle ascent grew progressively harder until it ended in a rope climb up what seemed an 80 degree slope! Truth be told, I was rescued on the treacherous descent by a group of local seven year olds that held my hand the entire way down. Although I have never been so dirty and utterly worn out, I couldn’t help to smile at the sense of accomplishment we all shared.
This past Friday we took part in a cooking demonstration at the HOPE Center. It’s meant to show women that are part of the nutrition program how to incorporate soybean powder into everyday dishes they cook at home. The staff also gave tips on how to make a meal healthier using local produce. As Nurse Love pointed out, why advise mothers to purchase expensive imported apples when pawpaw (papaya) and pineapple are readily available at the local market?
GHS Nutrition Officer Rita explained to me that it’s hard for many to obtain enough protein because the price of meat is high. However, a piece of fish can cost as little as 50 peswas (approximately 30 cents in US currency). She added smoked anchovies and a tablespoon of the soya powder to the okra soup, to be served with banku. She encouraged mothers to cook palm nut soup and palaver sauce with green leaves since they are a good source of iron and other vitamins.
Indeed, the demonstration did not just center on protein, but focused on the importance of a balanced and complete diet. Rita described and provided examples of the major food groups- fats (palm oil), carbohydrates (banku, akple, fufu, yam, cassava, brown rice), protein (fish, meat, eggs, beans), fruit (pawpaw, pineapple, mango, plantain), and vegetables (green leaves, spinach, onion, okra, arguably tomato). And the mothers weren’t the only ones learning- I can now explain that banku consists of cassava, while fufu is a mixture of fermented corn and plantain and akple is a lighter stable, consisting mainly of unfermented corn. Naturally, yam slices (my personal favorite!) are never served with a slimy dish such as okra soup, but is delicious with palaver sauce.
The best part of a demonstration is that it’s interactive- both in the preparation and consumption! The mothers did most of the cooking themselves, from stirring the cassava and water into banku to grinding the hot peppers, garlic and tomatoes together for a spicy stew. In the end, a modest supply of groceries were transformed into a feast for about 15 mothers and their children, not to mention the HOPE Center staff and volunteers. Perhaps most rewarding was watching a three year old child that three weeks ago could barely sit up due to malnutrition now eat a banana and play with his brother. Truly food brings a community together.
This Sunday we had the special honor of attending Nurse Love’s church, Holy Spirit Church. Since the chapel is located on top of a five story school building, it offers quite a fantastic view of the communities surrounding Ho. I’m not particularly religious, but as someone of Irish Catholic heritage that attends the occasional funeral or wedding I thought I had some idea of what morning mass would be like. Not quite.
Truth be told, the service was a lot longer than expected. We woke up at 6 AM to walk to the church before the mass started at 7:30. After we finally left at 11:30 AM, it dawned on me why virtually everything is closed on Sundays- church is an all day affair.
Still, the service was very enjoyable. I lost track of how many songs the entire congregation jubilantly sang. The lyrics and readings constantly switched between English and Ewe, the local dialect, just as the congregation was a mix of people wearing modern Western style dress or the colorfully patterned full length skirts and blouses with cloth draped over the shoulder.
After starting with incense and music, the reverend read a few passages in English and Ewe and delivered a sermon about how wisdom is greater than wealth or knowledge- indeed, it is one of the greatest gifts one can receive. Various members of the church also spoke, their speeches punctuated by the occasional “Amen!” from the laymen or even a song and dance. At one point some members brought baskets of bread, fruit and banku and we all danced down the aisles.
It was pretty obvious that we were visitors, but the welcoming aura of community was overwhelming. Indeed, towards the end of the ceremony new members and visitors were specifically welcomed twice, and afterwards we were greeted by the church president. Part of the service involves turning to all your neighbors and giving them a handshake.
After being here for a month, it is somewhat of a mystery why the plane here had so many missionaries. Christianity, both Catholic and Protestant, is everywhere and plays a central role in the culture and community life of Ho. At the same time, diversity is welcomed and we’ve been accepted regardless of our differences in faith. In any case, I was sure to get my measurements taken by a tailor so that I could get my own African style Sunday best.
Although the fresh pineapples are delicious, the palm trees inviting, and the weather warm, the best part of the GROW trip continues to be getting to know the dynamic personalities behind the HOPE Center. At long last, I am able to put a face on the newest member to our partnership, Head Nurse Perfect Titiati.
Although she was very busy preparing a series of two day workshops on recent developments in malaria treatments, she still greeted Parul and I on our first day with a warm “You’re Welcome.” A few days later, Parul and I attended the malaria workshop (a strong reminder for me to take my mefloquine!) where Sister Perfect introduced about 30 healthworkers to the topic and lead group discussions. She asked us to introduce ourselves and declare our main value. When one woman stated laughter Nurse Perfect mused, “Laughter? A value should guide us in all our thoughts and actions. It gives us direction. Tell me sister, do you laugh at a funeral?” Similarly, when one woman offered reading as a value, Sister Perfect quipped, “Do you read at a funeral?” The more I listened to her the more I was struck by her effortless blend of humor and wisdom into moments I’m sure will stick with me for years to come.
And what was Sister Perfect’s core value? As she humbly stated, hard work. Upon greeting Deepa and Neha she expressed her enthusiasm in meeting with us in the next few weeks to lay the groundwork for the future of our partnership. Through Nurse Perfect’s guidance and dedication to excellence, I’m sure the bond between GlobeMed and Ghana Health Services will be stronger than ever.
When I received a mail from the outgoing executives of GlobeMed 2009 introducing the next batch of students who will be visiting Hope Center in Ghana in 2010, I was really thrilled and at the same time curious. I wanted to know the caliber of students and how they can fit into our activities at the center like their predecessors. Mails were exchanged and my anxiety heightened by each day.
Between 13th June to 25th June Allyson arrived first, followed by Kathleen and Reema, then lastly Joey.
I christened Allyson, “Mother Allyson” due to her humility, wisdom and her approach to work; my anxiety and fears evaporated immediately as Allyson, the first to arrive quickly, grasped the whole concept of activities at the center. She soon took charge and started planning activities of her colleagues with such an ease that surprised every staff at the center. Her main objectives were to help develop the phase four of the nutrition program for the center and also help revise the partnership agreement between GlobeMed and Ghana Health Service. She worked tirelessly to achieve the objectives.
The ‘wide-eyed’ Reema was full of enthusiasm, zeal and have a great passion to work with us at the center. Her objectives were community mapping, and help with the continuation of phase three of the nutrition program. Her passion for the community work brought her closer to the two rural communities we serve, Ando and Kodzobi where she did a lot of interviewing to project the work at the center to the communities. Her final work is being used as a guide for our programs.
Adorable Kathleen’s volunteering spirit brought enthusiasm and youthful exuberance into our work at the center. She was always asking questions that helped her to achieve her objectives in helping to evaluate the Sexual Reproductive Health for Adolescents program and community-mapping. She braced the odds and worked among the rural communities we serve, and also made friends among the children.
Baby Joey, as I nicknamed him during his stay was the youngest. He continued with the electronic medical records and the community-mapping. He also worked hard among the two communities to bring out the way the community live, type of housing, water and sanitation, food, fuel used and family size. This information is essential for the center and we are using them to guide us in preparing community profile for the rest of the communities we serve.
The GROW 2010 team not only worked on their individual project but helped in most of the child welfare clinics by weighing babies and updating their records in the registers. They really fit into our system and worked very well. How we wish we could have them all year round
Yes, they did really had fun alongside their busy schedule, a trip to Wli waterfalls in Hohoe District, Kakum Park, the castles in Cape Coast, Kpetoe kente weaving town and of course, Kathleen’s birthday party at Sky Plus Hotel.
They were also ardent supporters of Black Stars, our national football team during the world Cup in South Africa 2010. Notwithstanding their “temporal” Ghanaian citizenship, they never forgot home whilst here. On the American Independence Day, I visited them in the house where they lived and we all sang the national anthem of their Home Country, USA. It was really a nostalgic moment!
I can still hear their voices giggling and their crazy music as I look forward to welcome GROW 2011, I really missed them. -MARGARET ASANTE, NURSE IN-CHARGE, HOPE HEALTH CENTER, HO.
“Ten years from now we will see this project grow out of the work of some students from the U.S. It will go beyond everyone’s dreams.” – Dr. Atsu, regional health director of Ho Municipality, in reference to the nutrition program at the H.O.P.E. Center
On Monday, the GROW Team and Margaret met with Dr. Atsu, the new regional health director of the Ho Municipality. During this meeting we discussed the role that Ghana Health Service (GHS) should play at the HOPE Center and the partnership between GHS and GlobeMed. Going into the meeting, we were all really unsure about how receptive Dr. Atsu would be to our ideas, but we were all really pleased with what he had to say. Dr. Atsu sees Ghana Health Service playing a major role in the H.O.P.E. Center and GlobeMed’s outreach programs. It was rewarding to see how well-received our work has been by GHS and the strides they are willing to make to expand this project to other communities. He stressed how important GlobeMed’s projects are, as they are one-of-a-kind projects, at least in the Volta region of Ghana. He sees the nutrition project as a model for similar projects throughout the Volta region, and thus wants to play a more active role in the research that the GROW Team and other GlobeMed students conduct. He wants all research conducted and all reports written to be validated and owned by Ghana Health Service so that our projects can be implemented in other communities.
Dr. Atsu also addressed the ideas of cultural competency and creating reports that accurately reflect the Ghanaian culture and mindset. As we all make progress on the reports of our various community surveys, it was important to keep these ideas in mind. What might seem significant and extraordinary in our eyes may be completely common place to the average Ghanaian. I was glad to be reminded of this idea that is constantly stressed in any discussion on global health projects. Even though I completely understand the idea of cultural competency and value its components, it is really easy and almost human nature to take a piece of data and place it in the context of one’s own culture. -REEMA GHATNEKAR
A little over a week ago, an In-the-Field Traveler from Global Giving published the review after a visit to the H.O.P.E. Center in Ho, Ghana. With Global Giving‘s permission, we have republished the report here. Thank you to author Andrew Meaux and Global Giving for supporting GlobeMed at Northwestern!
GlobeMED: HOPE Center
As most people know in development, the field is often more riddled with questions than answers. Common among these questions is how to measure an organization’s impact. Does one use fancy metrics to chart how a project develops and analyze data? Or does one rely on qualitative analysis, the actually question and survey approach of whether a person is better or worse off after a given project? Fortunately for me, GlobeMed, in partnership with the H.O.P.E Center, provided me both measurements over two days of unique site visits and insight into their remarkable work.
Day 1: Quantitative Data
As I walked into the office of Margaret Asante, the head nurse of the HOPE Center, the first question in my head was “what was on the walls?” Covering the right wall of the Center was a series of post-it notes each dated and named. Margaret explained that this was how the center was visually tracking the birth weights of babies until the age of 5. It was not difficult to extrapolate from these figures that the organization was having an incredible impact on the health of the rural communities. The center sees nearly 90 patients a day both male and female, has started a testing lab, and plans to expand its services to prenatal care. In metrics alone, under the leadership of Margaret, with support from GlobeMed, the HOPE Center certainly is high performing, but what do the communities say?
Day 2: Qualitative Data
After the details of day 1, Allyson along with three other members of the Northwestern GlobeMed summer team (Joey, Reema, Kathleen) led Alexis and I to Ando Village, one of the communities most impacted by the work of the HOPE Center. We all piled into a small taxi and weaved our way through cornfields until we reached the village and where we were greeted by a young woman named Esther. With some help from John (teacher) to rally the women, we sat down to learn about impact from the women themselves. At this point, I utilized what I call the “smile standard” (rating 0-10 on the size of a smile) to assess the project’s impact. The first impact indicator was the “10” smile of a young healthy girl sitting in the arm’s of her mother, after benefiting from an enriched diet thanks to support from the HOPE Center. The second impact indicator was the “10” smile of this girl’s mother, Cynthia, as the names of past GlobeMed volunteers were mentioned and the enthusiastic response the names elicited across the group of women. Thus, on qualitative smile standard, the project once again received high marks.
I can imagine within a short time, the names of GlobeMed’s newest in the field volunteers will bring smiles across the faces of communities such as Ando Village as they promote health through outreach. GlobeMed was instrumental in the HOPE Center’s founding and continues to aid in the Center’s expansion of services and outreach in the surrounding areas. The facilities made possible with GlobeMed’s startup support and sustained by the Ghanaian government provide the areas an essential health resource. No matter the way one measures impact, GlobeMed’s partnership with the HOPE Center is truly a success and I look forward to hearing about all the new and exciting programs as this relationship evolves. Keep an eye out for new updates from this project at www.globalgiving.org/2071 and you can follow the students in the field experiences at www.globemedgrapevine.wordpress.com.
If you are interested in donating to GlobeMed please visit globalgiving.org/2071
Andrew and four other In-the-Field Travelers are currently in Ghana before they are making their way to Mali and Burkina Faso. They’ll be visiting more than 30 GlobalGiving projects in the next month. Follow their adventures at http://itfwa.wordpress.com/.
Last week, we had the opportunity to have a meeting with a visiting physician from Ethiopia. He has had extensive experience in public health, spending a number of years working in a refugee camp. He also has a wide knowledge of the Volta region and a thorough understanding of the challenges faced by the communities serviced by the H.O.P.E. Center.
Our time talking with him provided us with deep global health insight as well as exciting avenues to take the Center’s outreach programs. For instance, he recommended more efficient ways to train peer educators for the sexual health program. There has recently been a lot of interest among church groups in the area for nurses to give lectures at their facilities. While this is great, it adds an additional work burden on the Center’s staff. Instead, this doctor recommended that we train a few peer educators within the church, who can then train others in their organization. This makes the program more sustainable in that it reduces the work burden on the nurses (who can now become the overseers of the program instead of the ones running the entire show). It also eliminates the need to keep retraining peer educators every year (a problem currently faced in the schools where the sexual health program is running). These principles can be extended to the childhood nutrition program as well: we will need to place more emphasis on making the program sustainable in the communities through peer education and personal farming tactics.
Our discussion provided us with a lot of valuable insight and great ideas to advance this partnership moving forward. The coming weeks will keep us busy working out a concrete partner agreement with the Ghana Health Services, outlining a strategic “5-year plan” for many of the Center’s activities, and developing new ways to advance outreach programs. We all came away from the meeting encouraged, inspired and committed to making our remaining time in Ghana the best that it can be!
So far, our time here has been amazing. Last Saturday, we went to one of the local bar/restaurants, White House, to watch the Ghana versus USA soccer game. We met some fellow American students, as well as many locals. It was amazing to see how excited the entire country was about the World Cup games, especially since Ghana is the last African country left. After Ghana won, the entire city began to celebrate. An impromptu parade began around Ho and the city was completely alive: people were singing, dancing, and hugging in the middle of the street, completely ecstatic about Ghana’s victory over the US. Tonight is the Ghana versus Uruguay game, so we’ll be heading back to White House to make some new friends and watch the game. Go Ghana Blackstars! – REEMA GHATNEKAR