Sara Blumenthal - Ghana Coalition of NGOs in Health
Monday morning Rob and I worked at the Coalition office and met with Mr. Boamah - the chairman of the Coalition in the Eastern Region. We mapped out our trip to the eastern region, and prepared all of the necessary documents/paperwork to confirm our clearance. The NGO leaders are very willing to speak with us – but the GHS directors are more skeptical/guarded and require different introduction letters from higher authorities. It has been an interesting challenge to meet with some of these officials. It is surprising to me how difficult it is to access public documentation. I originally assumed that it would be very easy to get information from GHS on the target health priorities and outcomes they measure (since they are a public entity working with public funds) – but it is not the case here.
We had a very productive and enjoyable time traveling with Mr. Boahmah. We met him at the tro tro station in Accra at 6:00am to set off for Akosombo (approximately 2.5 hours away). In Akosombo we first met with the director/founder of Drama Network – an NGO that has been in operation since 2002. They initially began as an organization that uses Drama and other creative arts to teach about health in rural communities. Since 2005, they have expanded to be the leading NGO in Akosombo addressing a variety of public issues. The founder is a very interesting woman, with strong managerial skills – and it is the most effectively run NGO I have met with so far. Because of the organization’s capacity – they have become highly effective in the surrounding communities, and have a very synergistic relationship with the district health office. They use trained GHS facilitators to do technical medical work in the communities – and are the sole entity responsible for identifying and training community leaders to teach about different issues in health.
The Drama Network office is located less than a mile from the Volta River – and the largest hydro-electric dam in Ghana. We were able to take a guided tour of the dam, which was fascinating. The dam was constructed about 40 years ago and generates enough energy to supply 60% of the electricity throughout Ghana – as well as some electricity to Togo and other areas just across the Ghanaian boarder. Building the dam required the Ghanaian government to displace 80,000 people living in rural villages along the river. To this day, the government continues to support these people with the resources generated from the sale of electricity.
After our tour of the dam we met with the disease control officer at the district health office and had the opportunity to sit in on a short segment of TB awareness training for local community leaders. I also had the chance to talk one on one with the Director of Drama Network about her thoughts on the effectiveness of the Coalition. She explained some of the reasons the previous National Director left – and confirmed my thoughts about the need for capacity building within the Coalition.
We left Akosombo and took a tro tro approximately 2 hours to Koforudia – Mr. Boahmah’s home town - and the location of the Regional Health Director. When we arrived in Koforudia we first met with a local NGO – 4H Ghana. They are somewhat affiliated with the 4H I have heard a bit about in the US. They initially started as an organization that promoted 4H clubs in local secondary schools – focused on teaching students about agriculture. Now, since they are established in the community, they have expanded to take on health issues – and are working with the Ghana Aids Commission on HIV projects in the community.
After meeting with 4H we went to the Regional Health Director’s office – and the highlight of my research so far, was meeting with the Regional Health Director. He had just returned to his office from a nearby conference, and graciously agreed to meet with us – even though it was the end of the day. I have been trying to get a meeting with the Regional Health Director in Greater Accra for about 6 weeks – so I was thrilled that this man was willing to speak with us. It was extremely useful to get his perspective on the relationship between NGOs and GHS. He also provided perspective on how information reported by NGOs to district health officials is reported and used at the regional level to impact policy priorities. This information will be extremely useful in providing effective recommendations to the Coalition.
By the end of the day, we were exhausted – and had a nice dinner with Mr. Boahmah who also took us to a close by guest house where we could spend the night. At 6:00am the next morning we met Mr. Boahmah again at the tro tro station and headed northwest to a very rural village in the Mountains. The village of Orowogabo has no electricity – and was even more isolated than most of the rural places I have visited so far. We met with the Director of the J. M. Rhode Foundation and toured the health facility they run in the village. This was the first NGO I have met who actually provides direct health services. About ten years ago they were able to create a partnership with a Dr. from the US. They have sustainable funding – and a very good relationship with GHS. GHS commissioned a full time nurse to work at the facility, and each year in June and July approximately 30 medical students from the US come to work in the clinic. The majority of local people see the nurse periodically throughout the year for small health issues – but when the doctors are visiting, they see approximately 500 people a day.
Thursday was a market day – so the head nurse was at the market administering immunizations and infant check-ups. We went to visit her there – and I found her very interesting and welcoming. Upon meeting her, she informed me that I was going to help with weighing the babies. The mothers undress the babies and put them in flour sack diapers with a large cloth loop that extends over the baby’s head. The infant is then hooked to a hanging scale, where the weight measurement is taken.
After meeting with the nurse, we walked around the market a bit – where Rob bravely tried palm wine out of a hollowed out coconut. We bought Kenkey (corn and cassava that has been cooked, mashed, and then cooked again in a large cassava leaf) and then took a taxi ride back to the larger village where we went to a chop shop to buy soup to eat with the kenkey. Prior to this experience I had the idea that Rob and I should challenge ourselves to Ghanaian food week (where we eat only Ghanaian food for an entire week), however, this lunch changed my idea about that.
We sat down at three small tables and “washed” our hands in a bowl of water in the center of the restaurant (and then again with hand sanitizer). Mr. Boahmah unwrapped the kenkey and another man ordered light soup with grass cutter meat (basically a large field rodent which is considered a delicacy) and fish (not just the fish meet – the entire fish: skin, face, bones, tail and all – cut into halves in the middle of the soup). Mr. Boahmah showed us how to “work the kenkey” (using your right hand you soften the food like play dough) and dip it into the soup. When the desire arises, you tear off pieces of fish or grass cutter and put it in your mouth while chewing the kenkey. They eat the entire fish/meat (skin and all) “gracefully” allowing the bones to fall to the floor in a pile. Mr. Boahmah explained that the bones are very good for your teeth.