It was a pleasure for me to be back again in Atorkor. Once again the hospitality & courtesy was wonderful. It felt very good to see some familiar faces and to be greeted warmly.
October 13, 2008
I arrived in the village and settled into the palace. I met with Seth Kodowu and discussed plans for me walk about the village to assess for prevalence of areas of open urination & defecation and rubbish dumping. After gathering my facts and seeing the situation first hand, the plan was for me to go into the school and the community to reinforce teaching on handwashing, hygiene and sanitation issues.
October 14th, 2008
A meeting of the village committee was held at the Residence and I was able to participate.
In attendance were: Seth Kodowu, Comfort Afornorpe, Steven K. Tettey, Assemblyman Mikail Kemevor, Godwin Adjorlolo, Manash Anaglo, Ebeneazor Yao, Justine Kudese
The following issues were identified as needing to be addressed:
- Proper refuse disposal
- Lack of toilet facilities
- Stray animals – there is a law but it is not currently being enforced
(right now, the issue of "stray" children defecating & urinating freely is a bigger issue)
- Well located near Danida latrine (on lagoon side) – are people still using the water, is it OK to use for wash water? Danida was under the impression that well is no longer is use but it is. Suggestions included having the well tested after the latrines are commissioned and in use. If water is deemed unsafe, it can be officially ordered closed by the Water & Sanitation authorities.
- Well water use for drinking & cooking – should use of tap water be encouraged and is availability adequate?
October 15th, 2008
Seth walked about part of the village with me and we both observed areas of environmental degradation due to inappropriate refuse dumping and public defecation/urination. Later, Paul Anthonio and I went for a walk. We went down towards the lagoon where I saw ground that was obviously used for defecation and littered with rubbish that was not far from family's residences and cooking areas. We saw children playing in the wooded area by the lagoon with no concern for their playmates who stopped to urinate or defecate and then continued to play in the same area that they had soiled in. I saw one little boy pick up some paper which looked to have already been used for the same purpose, to wipe himself after defecation. We also saw a number of children who did not appear to be in school yet were old enough to attend. It was on this walk that I met a young boy about 11 years old, named Atsu, who greeted me very politely. It was apparent that he was not in school. He was thin but had muscle development in his arms and chest that indicate that he was accustomed to strenuous physical labor. He indicated that his family are traders who spend time between here and Nigeria (although he is Ewe) and that his schooling has not been maintained. He was unable to tell me for certain what grade he should be in. Paul informed me that this is not unusual, even sometimes children are moving about and living with people who are not their parents for the purpose of providing physical labor. It sounds as if slavery in the Volta Region is still in practice. These children are lost in the cracks of society. It is very unfortunate. We went to speak with his mother to see why the boy, and his twin are not in school.
She greeted us warmly and did not appear upset at my concerns. She was pleased when I told her that her son struck me as being very polite and proper (which he was). I tried to encourage her to send him to school. I told her that times are changing and the world is not the same as when we were young. At one time, it was enough to be a fisherman or a trader but now more is needed to get by. I told her that her son needs an education or he will find himself left behind by the rest of the world. I suggested that with education perhaps he could even excel – he could be a doctor, a lawyer or even president! But without education, he could not be any of these things. I could tell she liked that – so much so that when we were joined by her senior mother, she was eagerly repeating what I had said. I asked Paul to followup on the situation and that I would speak with Madam Beaulah to see what it would take to get Atsu & his twin, Etsey , enrolled in school – if not this term perhaps by next. I know, I know, I am not here to help any one individual but I could not let this go by. The twin's mother stated she was relocating them to Aflau and they would attend school there. Inasmuch as it was made clear that there was interest in sponsoring these boys to go to school in the village, I cannot help but be suspicious.
October 16th, 2008
I went to see Dr. Atsu at the Offices of the Health Directorate in Keta. He was cordial and showed interest in the teaching/visual aids I had brought to assist me in my interactions with the school children. Our talk was helpful as he was able to give me perspectives on how to communicate with the children in order to get the right message across.
After leaving the Health Directorate, I went to the District Assembly in search of the Zoom Lion office. I was not successful in getting to see anyone at that time, but as I was leaving, Ms. Nancy DeSouza of GES stopped me. I ended up being introduced to Mrs. Freda Koasi, Municipal Director of Education, Keta District. She did not initially seem pleased to meet me but I was able to warm her up a little bit when she realized that I was aware of Ghana's handwashing initiative in the schools. I had to make it clear that I was aware of and respectful of the efforts already in place. Afterwards, they insisted on taking me to the DCE's office to present me. He was not in on that day, so I was introduced to one of his deputies.
October 17, 2008
I spent more time again at the school and around the village, observing and taking some photos. Also ran to Anloga (I take the trotro's alone now) to purchase some printer paper & pick up a few things.
October 18 & 19, 2008
Emmanuel came late that Saturday afternoon & stayed over until Sunday. He met with the microfinance group and we took a picture to send Samantha along with the reports. Sunday he was to meet with the nurse, Annette, but that was put off as there was a bit of an emergency when the other volunteer, Carrie, found a young woman who was literally dying on the roadside near the clinic. We took off to address that and when we returned, Emmanuel had left.
October 20th - 28th, 2008
I was given a schedule by Madam Beaulah to go into the individual classrooms. The younger grades were more difficult for me due to the language barriers. KG-1 has 96 children in one class, it is very difficult to achieve much learning with so many. I tried to interact with them directly, asking some children "En Kodi?" but I had difficulty understanding the answer. It seemed as if the children were giving me multiple answers. It was later from the Headmistress that I learned that many of the children do not even know their own proper names as at home they are often called something different. When they are enrolled in school, the names the parents register them under are not familiar to the children so when the teacher calls the roll, the children do not answer. Sometimes they have to get parents to actually come in to identify the children. This is something which needs to be addressed. There is such poor record keeping, no centralized birth registration and immunization cards do get lost. I have met too many children who could barely tell you their age, much less their date of birth. Madam Beaulah & I were discussing ways of increasing the children's awareness of these things, perhaps by making mention to wish children a Happy Birthday by the month at assembly or in class. Maybe on the first of the month, all children born in that month could be asked to raise their hands and the others could clap or "shine" for them. A very simple, NO cost idea that would serve the purpose. Lest you think ill of the educators for not having addressed these things already, I understand what it is to be overburdened by the immediate tasks at hand with limited resources. It is very easy for someone like me to come in from the outside with ideas. That's one of the things that makes volunteering important, having the chance to do that and actually make a difference.
I visited every class to talk about the importance of handwashing after toilet and before eating. Further, I talked with the children about the risk of disease associated with open defecation and urination. I encouraged them to use proper toilet facilities and that the older children have a responsibility to set a good example for the younger ones. I told them how I have seen children squatting to urinate or defecate just a few feet away from each other and then continue to play in the same area. This not hygienic or safe. It only takes one sick person to start an epidemic. In Africa and Asia, THOUSANDS of children die each and every day due to illnesses related to water and hygiene issues. This particular statement never failed to elicit some reaction when I used it in the upper grades & the JHS. That information combined with the knowledge that the little one mimic their behaviors served to reinforce for the older children that the example they set is important and could even save a life. Some of these children have already seen younger siblings sicken and die. Now they have a little power to do something that might prevent that.
I tried to impart that proper hygiene and sanitation are very important to keep a community healthy. Based on the amount of open defecation and urination I saw, I initially thought there were almost no latrines in the village. I told them that Atorkor is special to me so it bothers me when I see people who are passing through stop to use the village as an open toilet and trash dump.
There are some very bright students at Atorkor L/A Basic School. However, they need much support and encouragement to do well. Too many of them have no place to do homework, much less someone at home asking them what they learned in school. I would see some children at the side of the road near the chemist doing homework by the light of the shop or the lamp on the seller's cart. More often, I would see children on the road selling fruits and such from platters on their heads. As the library is set up and made more available to them, I hope they are able to take the time to read more. Reading is the best and easiest way to acquire English fluency, improve writing ability and to open up a whole new world. Madam Beulah and I were discussing this issue and we had the idea to adjust one of the teacher's hours so that she could keep the library open after school. Mrs. Georgina Patamia enthusiastically agreed to take it on. This should have been implemented by now.
On Sunday, 10/26, Emmanuel returned to the village again and was able to meet with the nurse Annette. We discussed the current practice of medical waste disposal. I expressed concerns about the lack of a proper method for disposal. It was agreed that to contact the Health Directorate in Keta to see what their policy for waste disposal is and if need be, an incinerator would be built behind the clinic. I suggested to Annette that in the meantime even using a metal drum to burn in would still be preferable to the current practice. Emmanuel stayed overnight for the purpose of having a presentation on Monday morning of the donated books and equipment from New Jersey. We took pictures which I was able to download with my laptop onto his USB drive so he could include it in his communication with Dr. Atsu-Swanzy. The poster paper I had provided the school was put to good use. The photo says it all.
I spent the remainder of the day preparing for my final presentation to the village. I had hoped to go out into the community to do a small sample survey of some households so as to get a better idea of how they view the current sanitation issues. Alberta Adjorlolo was to assist me in communicating with the villagers. However, I was running out of time and energy. When she came to the residence, I explained that I did not think I would be able to perform this task and apologized for taking away her time. Miss Alberta most graciously offered to take the task from me and with the help of her brother, Salem, she was able to perform a small sample survey regarding the hygiene /sanitation issues. The responses were honest as several responses included stating that they tell their children to "just go anywhere", to "go by the lagoon" or the "rubbish dump." 60% of those polled indicated that they or someone in their household has had nausea, vomiting or diarrhea in the past 3 months. Less than 3% reported any respiratory illness for the same period. 75% of those polled indicated a willingness to work with their neighbors to find a solution to the lack of latrines in the community. Miss Alberta was able to interview a dozen households in one afternoon and stated that out of those she spoke with, only one elderly woman refused to participate. In addition to gathering information, Miss Alberta used the opportunity to help reinforce the importance of proper toileting behaviors and hand hygiene to prevent illness. I wish I had been able to meet her earlier on in my stay as her assistance would have been most valuable. Now I know I have someone who is most willing to be of assistance to her community that I can call upon in the future.
ON the following day, Tuesday, the school had a ceremony attended by the Municipal Chief Executive, Hon. Edward Kofi Ahiabor. Following that event, before everyone dispersed, I was given opportunity (mandate?) to address those parents and adults assembled there to tell them of my observations and of the interactions I had with their children. Seth translated for me as I expressed my concerns regarding the health issues related to poor sanitation and open toileting. I had a jagged open can which I had just stepped on as I was walking back to the school. I showed this to the parents as an example of the danger of indiscriminate rubbish disposal. I had shoes on but what if one of their barefoot children had stepped on this in the sand? Or on one of the several razor blades I had come across while walking in the sand throughout the village? I invited them to come to the meeting place by the large tree on Dufia Street that evening for a slide show presentation showing them some of what saw and experienced this past week. Seth provided translation for me and it seemed that the message was well received.
That evening at dusk, Paul had set up the power point projecter using one of the walls of a home facing the meeting place as a screen. I had to pay one of the locals 3 Ghana Cedi to for him to allow us to run electricity from his home. I guess that should take care of part of this month's electric bill. Paul had a soccer video game that he used to entertain the young people as we waited for the adults to assemble. By no means was this a super professional presentation but it served it's purpose. Basically, I showed pictures I had taken in Ashiama and Nime to show examples of what happens to a community that fails to plan for the needs of a growing population. Then I showed some compounds that were well laid out with latrines and clean open areas. Then I showed photos I had taken of areas defiled by rubbish and defecation.
Since I did not want this to be an entirely negative experience, I then switched gears and showed them what I had found at the school and what I did with their children…
After showing some videos of their children in the school and an overview of the teaching materials, I continued with positive reinforcement and showed many pictures of the children which I had prefaced as referring to them as the
"THE WEALTH OF ATORKOR"
[This was taken from a picture I had taken of a T-shirt I had seen near Cape Coast in April of this year. You never know when something can be handy.]
After the slide show, we played a little video I had downloaded from WaterAid.org which they were able to enjoy and learn from. Afterwards, Seth reinforced the message in Ewe and ascertained that they had indeed been able to follow the film's story line without benefit of translation.
In addition to the activities described herein, I also spend time almost everyday at the chemist's shop. It was a great opportunity to interact with people. Sylvestor, the chemist, was always picking my brain for information. We learned much from each other. I know that he will be glad to share much of what we discussed with his customers. Sometimes other people would get involved in our discussions. It also gave me more daily contact with some of the young people. It was not unusual for a small child to approach me with a hand washing or tooth brushing motion to indicate what they have been doing. With the exception of the KG-1 & 2, where I left multiple packs of crayons & paper for their teachers to share out for use in class, I put something into almost every single child's hand – whether it was pens, pencils, soap, toothbrush, toothpaste, rulers or hand sanitizers – everyone got something so they would remember.
That pretty much concluded my activities in the village. On the following day, Prosper came to the village to pick me up to take me to Accra. It was full load as I had 3 travelling companions – Akpene & Bernard were going to Accra and Prince was accompanying me to Kumasi – and not realizing this, although I had communicated with Emmanuel, the driver had brought a friend with him to keep him company on the way down. It was pretty comical. For once I did not argue about being told where to sit as they gave me the front seat. J
It was the closest I ever heard Benard get to making an actual complaint. However, it all worked out well and everyone was able to get where they had to go. Emmanuel dropped me & Prince at the bus station where we then had our luxurious (air conditioned, 1 person per seat) 4 hour bus ride to Kumasi - make that almost 8 hours. We sat in traffic in Accra for >1 hour and then we had to stop because of the torrential rains… I am not complaining. It was all part of the adventure – I am just grateful and glad I had someone to keep me company and watch over me.
I really enjoyed Kumasi. It was different, so different from the village. We went to the Ashante Palace where I was invited to return on Sunday because they were having a festival and I could take a picture with the king. The old man making this request was so insistent that I asked him who he was. He stated that he was the King's Uncle. So again I told him that I was sorry that I could not come back on Sunday but I would be happy to take a picture with him, today. Which he did. Just as I was beginning the Museum tour, Vida called for me to meet her at the hospital. We made plans to meet later as I had already engaged in something based on being told earlier that she would not be available until 3pm. I am so glad that I did that. I enjoyed it very much, especially as it picked up where my tour of El Mina Castle in Cape Coast (last April) had left off. The museum tour was hosted by a young man doing his National Service requirement and his name was Prince. Too funny to see the instant male bonding at work. Haha.
Afterwards, I met Vida at Komfo Anoyke Hospital. She gave me a lab coat to put on – like that's all it would take for me to "blend in." I really appreciated the time she took for me and while she could not answer all of my questions – especially with regards to patient care challenges from a nursing perspective – she made every effort to make my "tour" as informative as possible. I certainly saw things I would not have otherwise. She is a dedicated young woman and I appreciated her taking the time for me. It was heartbreaking to see some of the conditions in the pediatric ward, a newborn with severe deformities whose mother had absconded, people with serious ailments patiently waitng in suboptimal conditions... The shortage of resources forces one to be certain to use them only where they may have a sure benefit. It's a bit different from where I come from. Vida was amazed when I told her that my hospital's mission statement is to "provide compassionate, appropriate care to all regardless of their status or ability to pay." I told her of how we treat foreign patients, legal and illegal, especially in cases of severe, life threatening conditions. Being a dialysis patient in a HHC hospital with no access to care in your homeland is actually likely to give someone opportunity to escape being deported. Quite the opposite of that poor Ghanian woman who was deported from her hospital bed in the UK.
Later that day, I went to the Cultural Center and enjoyed seeing the craftspeople at work. I saw many things I would have liked to purchase. Good thing I was low on funds at that point or I might have had too much to carry home.
We returned to Accra on Friday, not realizing that arrangements had been made for 3 nights in Kumasi. I felt so bad and I apologize for that, but after what the trip up entailed, I didn't want to get stuck travelling ALL day on Saturday when I was flying out Sunday morning. Plus I did want to go about Accra a little and go to the Botanical Gardens at Aburi. It's amazing that the trotro system works as well as it does. I think I was starting to get the hang of it. I was on the trotro to Aburi when a woman handed me a pen I had dropped on the ground outside, so I said "Akpe." Prince nudged me and said "wrong language ." Before he could say anything else, I quickly said "Medase." Everyone laughed, enjoying my effort. I had many teachers throughout Ghana. Once I tried, people were always encouraging me.
In any case, I was grateful that to have someone to keep me company and keep me out of trouble. I like to wander about, seeing things first hand, going into neighborhoods (good & not so good) to see how people live, interacting with shop keepers – I would never have been able to travel so freely if I had been alone. I became pretty accustomed to having a companion/bodyguard during my time in Africa. Even in the village, there was always someone checking up on me – be it Benard, Paul, Seth, somebody was almost always around. I can honestly say I have never felt so well cared for – not even as a child. When I tell this to the people I work with , they are amazed – except for my African coworkers who are quick to assure them that it is true. I now have a new nursing assistant from Nigeria working with me and it seems that he has picked up where Bernard and Prince left off. If I go somewhere and he is with me, I don't carry anything. He is always ready to help me. I love it. I am finally spoiled. :)
