Babies, medians and reflections

January 9-10

Pack and early breakfast at the Inn. Joe and Daniel Kwarteng come to say goodbye.

Drive with Kipharts and Olopades to the Kumasi Clinic, a maternal health care clinic that the Kipharts and, through their efforts, a foundation in Spain have supported, including construction of a new building an a modern lab. Here’s our favorite driver, Sammy.

The Kioharts contact at the Clinic was Dr. Annie Opuku, a Madagascar-born, Russian-trained doctor, with a wonderful and caring heart. They had supported Dr. Annie on an ad hoc basis, responding to her requests from time to time over many years. With the Kipharts having changed their efforts to go through the Olopades, far more rigor and accounting was required, and Dr. Annie was not able to do this. Recently, Dr. Annie has left the clinic and is working elsewhere. The whole thing is complicated by the close personal relationship between Dr. Annie and the rest of us. She attended both dinners in Kumasi, the second with her son.

Dr. Ansong, a Ghanaian doctor who is working with the Olopades on projects in Ghana set up a meeting for us with the new acting director of the Clinic. Dr. Annie inserted herself into this meeting, which made for real awkwardness. We discussed current work in the Clinic. The Olopades feel strongly that the Clinic is missing out on a great source of revenue, by failing to market it’s excellent and very price-effective lab services to the outside. We also discussed possibilities of partnering with the Clinic, through Dr. Ansong, to provide health services in some of the villages that the Kipharts are supporting. Exactly what form that partnership might take needs to be explored.

We toured around the maternity clinic, early child care area and the lab, as reflected in some of the photos below.

Clinician, Acting Director and Sola, Dr. Ansong in back, in lab


Dr. Ansong and Funmi in lab

Dr. Annie and brand new twins

We left the clinic by 10AM for the long drive back to Accra in two separate cars. We and the Kipharts are leaving five hours after the Olopades, but decided we’d head in at the same time so that we could stop at the Kofi Anan art gallery, which we have visited with the Kipharts on two other trips. The plan was for the two cars to meet as we entered Accra, transfer people and luggage between cars and then go our separate ways.

What had been a relatively dull day became a good deal more exciting when a big traffic tie-up began (slightly) to threaten the Olopades making their plane. To avoid the traffic jam, Sammy drove the car with the women over a median strip in the highway, and phoned our driver, telling him to do the same. Our driver was understandably reluctant to do so, as the median was not a small one, the curbs were high and the oncoming traffic into which he would have to turn swift. Eventually Dick and Sola coaxed him into doing it, and he was promptly pulled over to the side of the road by a police car with its lights flashing. Two incredulous and irate police officers shouted at our poor driver, but eventually allowed him to go, without ticket or bribe, probably because Dick and I were in the car.

The Olopades continued to the airport, making it in plenty of time, and we and the Kipharts enjoyed an interesting 45 minutes at the gallery, doing only very minimal damage. We were dropped at the airport and went to the restaurant, where I had an excellent cheeseburger and fries, making me feel almost home. Got through ticketing, immigration and security quickly, which is always the case when you have three and a half hours to spare. We’re currently relaxing in an airline lounge, awaiting our flight to Frankfurt.

 

Reflections on the trip.

At breakfast on our last day, Funmi said that her favorite part of the previous day was the chief in the last village we visited. When I asked her why, she said “because he greeted the Kipharts by saying, ‘I remember you. You came here nine years ago, and you gave us clean water.’ That’s why you do this work, ” Funmi said, passionately. “You may not remember the village (when the Kipharts saw the village name on Alex’s itinerary, they had not recalled going there), but he remembered you. You do not know who you are going to touch, but they will remember you and what you did. And when you’re bouncing up and down on that bumpy, dusty road, you may think, ‘why do I need to be doing this, when I could be so much more comfortable back in Chicago.’ But if you can touch one person every day, then you have really done something.”

These trips indeed take us out of our comfort zone. Physically, they are difficult, and they don’t get easier as the years pass. Because of poor water pressure in Kumasi, Carol and I learned a new skill–taking a bath with half a bucket of warm water.  But much more than physically, they take us out of our cultural comfort zone.

You learn how people different from you in so many ways share a common humanity. You see the strength of the human spirit, enduring–no, more than enduring, rejoicing–under conditions that would be almost unimaginable to you. When you travel the dusty, bumpy road, you are reminded that this is the road that people in the village must traverse to get to a hospital, and not in air conditioned SUVs.  You imagine what these dirt roads are like in the rainy season and wonder how children in one village can get to the nearest secondary school, five miles away.

In other words, you learn of how privileged a life you lead and of the tremendous number of things that you take almost completely for granted. Probably the most basic of these is where the Kipharts started their work–water. Providing clean water makes all the difference. And when you add hygiene and health care to clean water, you completely transform people’s lives.

You are reminded on these trips that the food you slipped a credit card out of your wallet to purchase at the grocery store was produced only with great effort under very difficult situations. And you see that people in remote areas have enormous intelligence and abilities that you come to respect and admire. You learn how much you do not know or understand and how you do not have all, and may not have any, of the answers to problems others face, that you must listen, observe and trust others to solve their own problems in their own ways.

For all of these lessons, learned or re-learned, this was a great trip. These lessons are worth trying to retain and worth learning again. And again. Because they are not at all easy lessons to retain when you slip comfortably back into the world you left behind on this trip.

We were able to see and appreciate the tremendous growth and evolution of the Kipharts’ work since we started traveling with them five years ago. Much of this growth and evolution is due to the Olopades guidance and execution. It was wonderful to witness Peter Eduful’s son, Alex, take over the work that his father started.

On a more personal level, the trip allowed us to reconnect with friends we’ve made in Ghana over five years and in Nigeria, over two. And nobody who has read this blog can fail to appreciate what a pleasure it is to travel and laugh with, and learn from, our friends Dick and Susie, and Sola and Funmi.

If asked to pick the highlights of this trip, I would choose two at opposite ends of the experiential spectrum that bracketed our time in Nigeria and Ghana, the glamour of the fabulous engagement party in Lagos on our first full day of the trip, and our visits to the wonderful, but decidedly unglamorous, rural villages near Kumasi on our last full day. And there was some pretty terrific stuff in between.

Thanks to all of you who came along and have shared your comments. Now rest up a bit. We take off for Namibia in three months.

 

 

 

In the Villages

January 8

When the Kipharts began building wells in Ghana a dozen years ago, their principal contact was Peter Eduful, a Ghanaian who they had met through a mutual friend when Peter spent some time at the University of Chicago. Peter handled all logistics, contacts and finances for the Kipharts, eventually leaving his government job to work full time for the Kipharts. He was kind, deeply religious, competent and totally trustworthy. When Peter died suddenly, at 62, of a heart attack two years ago, it threw a complete monkey wrench into the Kipharts Ghanaian plans, and they began searching for a way to continue to operate. Feuds erupted between members of Peter’s family, some of whom he had employed, with the Kiphart’s knowledge, who thought they were “entitled” to assume Peter’s work. Not wanting to get in the middle of this feud and unsure that any family member had the skills to do the job, the Kipharts thought they would need to look elsewhere.

With the Olopades suggestion, we interviewed Peter’s son, Alex, a very bright young man with an architectural degree from Harvard. I was highly skeptical, not because he didn’t have the skills, but because I was uncertain he’d make the necessary commitment, with all the other things he has on his plate. Happily, I was dead wrong and, with Sola’s guidance and mentoring, Alex has produced several reports documenting the status of the 70 or so wells, conducting needs assessment interviews and making recommendations. We’ll be going with Alex and his partner in this effort, Frank, to visit a number of these wells today. (Last night at dinner we saw photos of Alex’s new twins.). This is a very happy and heartwarming ending to the story that began with Peter’s unfortunate premature death.

After breakfast at the Inn, we drive over two hours to Bonkwaso, the first stop of the exceedingly ambitious agenda Alex has set for us today. Traffic is heavy and the air quality terrible, aggravated by the dust because of the dry season. Once we get off the main road, travel is bone jarring and the dust from the dirt road so thick that we need to maintain a big distance from the other vehicles in our group. Several of us, including moi, have developed persistent coughs.

Rather than try to describe each place we stopped in detail, I’m going to give you the overall picture as best I can. The Kipharts, through the Olopades and the Center for Global Health at the University of Chicago, have embarked in the last couple years on trying to partner with villages, generally through their chiefs, and with governmental units (districts) so the the villages and government are sharing responsibility for water, sanitation and health rather than merely accepting gifts from the Kipharts. This is not an easy transition to effect, since the villages understandably liked getting unfettered gifts and districts were not averse to having their obligations performed for them.

The Kipharts decided to try to set up two model projects in the same district, Bonkwaso and Abasua, and those were the first two places we visited and the spots we spent most time at. In the first, the chief was resisting the new plan strongly, but Sola minced no words in letting him know definitively the way things were going to operate. My guess is that this chief is going to get it very quickly–he’s quite smart–and will operate well under the new rules. The second chief definitely gets it already. In both places, a representative of the district, with whom Alex had been in touch was present, and this was very helpful in conveying the message. After this meeting we had a terrific us scheduled meeting with the head of the district, who could not have been clearer in his understanding of, and support for, the new approach, saying, “Of course, if we do not do things for ourselves, how can we expect that you will do them for us?” These three meetings were enormously encouraging, and signaled a major change in operations achieved in a very short period of time, thanks largely to the Olopades and the excellent work that Alex Eduful has done.

We visited three more villages, involving substantial drives over bumpy, dusty roads. In each, we saw a well in operation, were greeted by chiefs and elders, had our, hands shaken repeatedly, told, “you are welcome, akwaaba,” exchanged speeches and saw adorable children.  We go through a ritual of being asked, “what is your mission” and replying as to why we have come. Though I’m not making this sound so appealing, it actually is very interesting and great fun. I took many photos, a sample of which I include below, including members of our team, chiefs, children ( for which I’m a complete sucker) and a final photo showing a typically religious name for a retail establishment.

Alex


Sola and Jonathan, from the water district


Abasua Chief


Dick and Chief

Okay, so I went a little overboard with the kids.

We drove back to the Inn, tired, dusty and badly in need of a shower. Half an hour later, we were off to a dinner attended by about twenty people, including all the people I’ve mentioned in this blog and five or six others who we’ve met on prior trips, including Dr. Annie and her doctor/son Robert, Alex Awesua, who has helped with the wells since Peter Eduful was involved, Dr. Ansong (of whom more tomorrow) and Phillip a terrific, young school headmaster. Everyone introduced himself and said a few words, which contributed to a very warm, family atmosphere in which everyone was genuinely glad to see one another.

Afterwards, we drove back to the Inn. The Kipharts, Olopades and Kanters spent half an hour or more debriefing the day and discussing future plans, as is our practice on these trips. Retired, with plans to awaken early for our last day.

 

 

 

 

 

 

 

 

Pineapples Are Not for Sissies

January 7

Breakfast at the hotel with Kipharts, Olopades and Joe and Daniel Kwarteng evolves into an interesting discussion of challenges for pineapple farm and potential solutions. A good deal of the discussion revolves around difficulties in finding a sufficient number of people willing to do the very hard, grueling work. This stems in part from the disfavor young people hold agriculture in. It lacks the pizzaz of other fields and does not hold the promise of big rewards quickly. The best worker on the farm is a deaf man who graduated from The Cape Coast School for the Deaf, an institution that Joe Kwarteng and his wife, Ida, and the Kipharts have supported and which we have visited several times. They plan to actively recruit more deaf graduates. It’s also clear from their experience that women are more willing workers than men. Most of the women have young children, many more than one, so child care is an issue.

We set out with the Kipharts and Olopades on the short drive to he pineapple farm, which is a private for-profit venture of Dick and Joe Kwarteng, the former Dean of Agriculture at Cape Coast University. Begun about three years ago, the farm consists of several plots totaling about 2000 acres, of which around 450 are currently planted. The vast majority of the land is planted in pineapples, but recently they have devoted smaller plots to trying mangos and limes.

It’s always fun to visit the farm and see the progress that has been made. The large pineapple fields are quite beautiful, spread across hills and lower lands. We drive around to observe and hear about the plantings and meet some of the workers.

Dick cutting pineapple

Joe Kwarteng

Daniel Kwarteng

John, Field Manager

The overwhelming sense I’m left with is that it’s a hell of a long way from these fields to Whole Foods and that agriculture is definitely not for sissies. We hear all about the pitfalls that have befallen them in a short time. Too much rain. Too little rain. Fungus. Marketing difficulties and buyers falsely falsely claiming fruit delivered was bad. Many acres of plantings ruined by flooding caused by heavy rains. Plants maturing too quickly, requiring that they be sold locally (rather than overseas) at a low price. Timing of getting things to ships. Delays because of traffic. Delays in the packing house, causing them to miss a ship and therefor lose the crop (they’ve concluded that they need to build their own packing house, which will cost $500,000). Very hard work, planting, weeding and picking; long hours in the hot sun.

After a couple hours, we set off on the long drive (4 hours plus) to Kumasi, stopping for lunch at a very nice hotel/restaurant overlooking the sea, fanned continually by cool breezes. We complete the drive and arrive at The Four Villages Inn, our home in Kumasi, where Carol and I stay in the same room each time we come. We’re greeted by Frank, the son of the owners, Chris and Chastity, to whom we all express condolences at the very unexpected death of Chris in surgery in Canada less than a month ago. In less than half an hour, we’re settled into our rooms and are off to dinner at a Chinese Restaurant, with the Kwartengs and their two sons, Alex Eduful and several others. We’ll be spending tomorrow with Alex and his right hand man, Frank, visiting wells, so I’ll save the Eduful story for then.

 

 

 

 

Cocoa, Traffic and Off to Ghana

January 6

Down for breakfast in the hotel.

Email from Sola. Once again, the best laid plans…so, unfortunately we will be unable to visit the home of a woman who is participating in the study Sola told us about last evening. So, I’ll tell you about it anyway, because it’s so interesting.

Sola is a pulmonologist who has a particular interest in indoor pollution, which he says kills over 4 million people annually, primarily women and young children, who suffer the effects of mothers cooking indoors without ventilation. He is conducting a fascinating study in Nigeria, designed to show the impact of indoor pollution on mothers and infants. He has enlisted 300 pregnant women, one-third of them are using new stoves he has provided that burn ethanol, a clean fuel. The others are equally divided between women cooking with wood and with kerosene, both of which are dirty fuels. Along with over twenty researchers he is supervising, they are conducting detailed tests at various stages of pregnancy on the fetus and the mother, and will continue with a longitudinal study that traces the subjects for five years after birth. The study is carefully designed to control for differences in nutrition, and other factors that could skew the results. Sola is justifiably excited about the study and the enormous impact it could have on saving lives.

The stoves are very inexpensive. The trick is to convince people to use them, and to assure that there’s a supply of ethanol. Sola, with his typical ingenuity, has convinced Shell Oil to donate the ethanol for his study and gotten Ibadan University to allow him to put a tank on their land. We’re sorry not to be able to see the stoves in action, but will look forward to hearing the results after the 2-year study is completed this August.

We meet the participants in an early morning meeting that Funmi is holding at our hotel, including the head of pharmacology at the University, a woman named Peace who we met a year and a half ago. Peace is collaborating with Purdue University on a project relating to assuring quality in African medicines. She is looking to build a lab, and the Kipharts will put her in touch with a foundation in Spain, who through the Kipharts, has constructed a lab at the clinic in Kumasi, Ghana that the Kipharts support. We’ve visited that maternal care clinic on all of our four trips to Ghana, and we’ll see it again in a few days. Ain’t globalization somethin’?

Not to air our dirty laundry, but we got into some rather spirited discussion with Funmi about the use/waste of our time on this trip. She apologized, but explained the reasons why not everything turns out as planned and we needed to be more patient. The air has been cleared, I think, but the incident shows that cultural differences surface, even among good friends. I later joked that I was going to entitle this post, “Fighting with Funmi.” She laughed, but it was clear that she would not have thought that very funny.

We set off with our security guard and Sammy, our protocol officer.

En route with Funmi we are able to discuss a range of topics, ask her about things that may have been unclear to us, and explore new topics. The slight bow/bend of the knee that we see frequently is a sign of respect from a younger person to an older person (regardless of gender; “age trumps gender,” Funmi says, and we applaud). The money passed out liberally at parties is part of the compensation for servers and performers (like tips) and a way of defraying the costs of the affair, when given to hosts. Funmi sees a sign of hope in the troubled Northeast. The newly elected emir was a former treasury secretary and an outspoken critic of corruption. In fact, he did a terrific TED talk. Anyone interested can email me and I’ll find it for you. He is effectively the king of Cano, the second largest city in Nigeria. A sign of the incredible connectedness of the Olopades is that recently they met the emir at a big birthday party, because he was and old school friend of Ayo’s (the groom) father.

We head to CRIN, Cocoa Research Institute of Nigeria, a government-funded institute that actually deals not only with cocoa, but also coffee, kola, cashew nuts, and tea. They do extensive research on all of these crops, seeking ways to improve them. The Kipharts have indicated some interest in possibly investing in cocoa and the Olopades, when they came in August (on the trip that we and the Kipharts were to have joined them on) did quite a bit to explore potential cocoa investment possibilities, particularly in Ekiti State, which we had visited in August, 2013.

The meeting with four CRIN scientists lasted about an hour during which they explained their operations and answered questions. Dick pretty clearly was not impressed with them as a possible investment partner. We then went out to the nursery to see the cocoa plants and the grafting process which has created hybrids that greatly out perform other varieties. Seeing is a good deal more fun than listening, especially when the difficulties of deciphering accents are compounded by the noise of construction outside.

We headed out on the long, bumpy and dusty ride to the Lagos airport. For quite some time, there is heavy traffic, causing vehicles to form not one, but two, lines on the shoulder of the road jockeying for position both with other shoulder riders and with traffic on the main road, which vehicles enter and leave whenever there’s a perceived gain of a couple car lengths in doing so. The scenery on the side of the road is not uninteresting, composed of commercial areas, large gatherings of trucks and animals. Vendors risk their lives wandering in the midst of passing traffic, trying to sell drinks, food, gum and all manner of other things.

We reach the airport a bit over an hour before scheduled flight time and find the international terminal very uncrowded, as most international flights leave late in the evening. More to the point, the Olopades rule the Lagos airport, getting us quickly through baggage inspection, getting the check-in people to allow us extra bags without cost, convincing an inspector to allow Susie to take on a glass container that they had nixed, getting an airport employee to inform us in a lounge we occupy when the flight is ready and arranging for us to skirt the line at the gate. We have drinks and a snack in a new public lounge, then board the flight, which is about an hour and a half late.

The flight to Accra, the capital of a Ghana is less than an hour. We’re met at the airport by Daniel Kwarteng, the son of Joe (and Ida) Kwarteng, Dicks partner in the pineapple farm we will visit tomorrow. We’re greeted very warmly by Daniel, who we’ve met several times before. Going to Ghana is very much like coming home to us now.

We ride with Susie in a very comfortable car, driven by a young man named Sammy. Daniel drives Dick and the Olopades in a separate vehicle. We’ve decided to drive a couple hours tonight in order to be able to get an early start at the pineapple farm tomorrow and to be closer to Kumasi. En route, we pass a huge brand new shopping mall that opened a couple of months ago. I’m afraid to ask what stores populate it. At the same time, we see hundreds of young people walking the center line on the highway at night trying to hawk their wares, clearly at great risk to their lives.

Our two-hour drive takes three hours. The hotel appears perfectly fine, except that the wifi they have doesn’t work, so I won’t be able to post this blog or check emails. I was intending to have just a beer for dinner, but the buffet dinner which includes rice, vegetables in a nice sauce and prawns is good enough to go back for more. Joe Kwarteng is there with 8 or 10 of the people who work on the pineapple farm. The latter give an update on what’s going on there, but because of poor acoustics, generally bad hearing and Ghanaian accents, which differ from the Nigerian accents we’ve acclimated some to, I only get about half of it. Up to bed by 11.

 

Academic Interlude

January 5

Water pressure in the house makes showering impossible, so we’re planning to move to a hotel this evening. I probably could have survived without showers, but I draw the line at no wifi. I mean, c’mon. Susie says, “we could have done with this, if we had to, but, if you don’t have to…..” I told Susie that that pretty-much summed up my philosophy of life. I’ve never been one to skirt the moving walkways at airports.

We have breakfast at the house, eggs with a bit of a kick to them, fresh orange juice, toast and sausage, with Nescafé. We’re met at the house by the deputy vice chancellor of the university, EmilOlorun Aiyelari, who we are told we can call Ambrose (we Americans are so bad at making the effort to learn and pronounce foreign names), and taken over to the school, where we meet with 8 professors from all facets of the agriculture school– including forestry, agronomy, fisheries, wildlife, plant breeding and crop production, ecotourism, entomology–and see the work of a woman who is doing new research on cocoa plants. The Kipharts are reasonably knowledgable on some aspects of what we discuss. For Carol and me it is almost entirely a learning process (though each time we are exposed to it, we absorb a bit more). Those we meet with are obviously very experienced and expert in the areas we discuss. Their various different accents require close attention in order to absorb what is said, but the three hours we spend is quite interesting and rewarding. One common theme in all the agricultural areas is that for any work they do to be effective it needs to be built from the bottom up, paying close attention to what the farmer wants and is willing to do.

We returned to the house for a very good lunch, and assembled our luggage for transfer to the hotel.  Wasted quite a bit of time, first driving to the University, then to the medical school  to meet Funmi and finally back to the Unversity for a meeting with the Vice Chancellor, Isaac Adewole, who we had met a year ago August.  Isaac is a powerhouse in his last year as Vice Chancellor and talked about what had and had not been accomplished under his tenure, and about an exciting project in solar energy that they plan to do with the government of Germany.  Isaac has a clear vision for the university and is very bullish on both the University and Nigeria.  He predicts that all of the troubles we read about in the Northeast with Boko Haram will die out within two years.  He also thinks that the huge drops in oil prices will ultimately benefit Nigeria by forcing it to diversify and look to agriculture as one of its primary assets.

We drive to and check into the very nice, new Owu Crown Hotel, where the protocol officer who has accompanied us all along (“Samuel,” though that’s nothing close to his real name) negotiates a 30% discount because of our affiliation with the University, and we are given a suite.  We barely have time to wash up, before we need to set out for dinner, hosted for us and about 25 university professors outside at the home of the Vice Chancellor.  Driving there I realize that I’ve become so used to the African urban landscape that I barely notice what has fascinated me on prior trips and what I know first-time visitors would gawk at.  I’ve included a few not very good photos, taken as we whizzed through in our van.

 

En route to the dinner, Sola tells us details of a fascinating study on indoor pollution that he is in the middle of. I’m going to hold the details until tomorrow, because it will fit better with what we are doing then. The dinner is quite pleasant, though I’d have enjoyed it even more if I had a richer appreciation for the nuances of poultry nutrition, the specialty of the Dean of the Agriculture School, who was seated next to me. We are showered with many gifts by the Vice Chancellor. Clearly, the VC feels that a relationship with the Kipharts is worth the very substantial amount of attention, time and effort that he and his faculty members have spent with us on our two trips. Another reason is undoubtedly the esteem in which two distinguished alumni of the University, Sola and Funmi, are held. Funmi does not attend the dinner, spending the evening instead with her 94-year old mother.

We drive back to the hotel, past night markets lit by kerosene lamps, and retire early.