Healthy Start

After the rough arrival, our first real working day was a decided step in the right direction. Slept well, and courtesy of a loan from Dick, was able to put on fresh clothes for the day.

After a good breakfast at the Inn, we set out for Dr. Annie’s clinic in Kumasi, heavy city traffic making the short drive take at least half an hour. Ida joined us (“us” generally means the Kipharts, the Olopades and Peter). We learned, somewhat surprisingly, that all seven of our bags had been located in Accra and that Jonathan had picked them up and was headed our way. Apparently, our bags had decided that they would get a kick out of flying to Morovia and back yesterday. I’m hoping that they had a great time there.

Every aspect of Dr. Annie’s clinic is a huge beehive of color and activity. From the maternity ward, where six mothers who have just given birth and their less than twelve hour old babies lay stretched out on cots, to clinics for well babies some of whom were brought in by grandmothers or sisters of deceased mothers, to a laboratory, to the room where powdered compounds of baby food are put in transparent sacks to places where babies are weighed and inoculated. A few photos may give you some sense of the place, first one is of Dr. Annie:

Having been here three times, it’s fascinating to see the changes/improvements in the clinic financed by the Kipharts, by a foundation in Spain who the Kipharts introduced Dr. Annie to, the Ghanaian government and the Lakonishoks (other Chicago friends of the Kipharts; Margot went with us to Ghana two years ago). The entire place is bustling and, as Funmi commented, the children all looked clean and well-dressed and the mothers (or mother substitutes) engaged and attentive. Though clearly it could benefit from some further administration, Dr. Annie has done a remarkable job.

We spent a few hours at the clinic, shown around by Dr. Annie, who explained what was going on in each area. After this, Ida left and the rest of us went out for lunch at a restaurant in Kumasi.

Having Sola and Funmi along is fabulous. They are fun companions, for one thing. But way beyond that, they are extremely knowledgable, about what we are seeing in specific places we meet, about how to accomplish change in a global health environment and about the culture of West Africa. Their observations are astute, their questions direct and their sense of humor lively. Their contributions are central to making this trip work.

It’s tough to report on (or even remember) the many and diverse things we talk about en route. To give some idea, though, here are some topics I recall from today: growing up in Nigeria, their very talented children–Feyi, Dayo, Tobi, all in their twenties and in the US–the support families give to mothers in their homes in West Africa for forty days after they give birth, end of life issues, the importance of paraprofessionals in the medical (and other) professions and African philosophy–everything will be okay in the end, so if it’s not okay, it isn’t the end; in Africa, we control time, in the West, time controls us. I’m sure I’m forgetting many topics, and merely listing them can’t possibly give a true sense of the richness those conversations add to the trip.

The other two stops, after lunch, were much less colorful, but quite important to the purposes of the trip, since they gave us a far better sense of how the levels of medical care work in Ghana, the Ghana health insurance system and how the Kipharts might partner with existing providers. All of this emerged from skillful questions asked by the Olopades.

At the first place, the Juaben Government Hospital, we met and were shown around by Dr, Prosper Gbekor, the medical superintendent. He runs a very well organized and equipped hospital, which has laboratory facilities that permit firsthand research on malaria and other matters. We also met Esther, a young Community Health Worker, the type of person who may be very important in the work the Kipharts would like to do.

The second place, the Kwaso Health Center is a small operation that has no doctors on staff. It provides direct medical services to people, 95% of whom are covered by government health insurance. When medical matters are complex, patients are referred to other facilities. We talked about how the incredibly cheap ($15/year) fees are used to support the services. Our general sense was that the very small rural villages Dick and Susie are most interested in are not currently being served by the system, but could be brought into the existing structures. We’ll be able to test this hypothesis more tomorrow.

The Kipharts recently purchased two motor cycles to allow those who work with them to reach some of the remote villages. One of the well diggers drove one of the cycles over, and I’m sure one of the memorable photos from the trip will prove to be Susie aboard the cycle.

We drove back to the Inn and, after a tearful reuniting with our luggage, we were joined for dinner by Dr. Addae, a Ghanaian-born, German trained doctor who has been interested in and involved with rural health for many years and was actively involved in helping to conceive the national health system in 2001. The Kipharts have been involved with Dr. Addae on and off over the years, and we met him on both of Carol and my prior trips. While he is bright and interesting, the prior dealings have not always worked out so well and so it’s not likely he will be involved in the Kipharts new projects.

We retired early and I worked on the blog. Looking forward to a totally different experience tomorrow, when we visit some small villages.”