Bring healthcare to 7 deprived Mamprusi villages in rural Ghana: Zambulkura, and six nearby communities.

Location

Zambulkura and its six neighboring communities; Tichirigitaba, Jarigitinga, Sumanitinga, Boritinga, Yonyooranyili and Zamblugu, are situated in the remote and deprived East Mamprusi District in the Northeast Region of Ghana, West Africa. Here, 10-20 km from the nearest healthcare facility, all households are dependent on small scale agriculture to earn a living and provide for their families.

Between 95% to 98% of all the community-citizens, have never been to school and cannot read or write. This is in stark contrast to Ghana’s country average of 71-72% being literate. Approximately 5000 people, of which approximately 1500 children under 17 years of age, have no access to nearby schools, healthcare facilities, or running water and sanitation.

The nearest school and hospital is in Nalerigu and the distance is between 10-20 km. The means of transport available are walking or motorbike – neither ideal when you are ill.

Healthcare not accessible

When healthcare is needed due to injuries, illness or during child birth, citizens need to go to the Nalerigu hospital, which serves several communities in a radius of up to 60 km, leading to overcrowding at the hospital. The roads from these communities to Nalerigu are not good, especially during the rainy season, when many communities are cut off by flooding.

Walking - or motorbiking during the rainy season - to the hospital always results in patients arriving to the hospital late, unable to receive treatment the same day. Finding sleeping places in Nalerigu to spend the night and continue the next day in their effort to access healthcare, is a huge challenge and health can deteriorate fast as a result.

The difficulty in accessing healthcare in Nalerigu creates suffering and frustration, making community-citizens delay or or completely avoid seeking healthcare, leading to complications and often; the loss of lives.

Pregnant woman in labour, going to Nalerigu, to give birth, on motorbike. Zambulkura 2015.

Basic health problems threatening lives

The most vulnerable in these communities are pregnant women, children and the elderly.

The death from malaria in children is still in the range of 2-3 % per year. The elderly often suffer from prolonged health problems which the communities and families lack the knowledge of how to help or better. And when complications arise during child birth, no help or means of transport are available.

The lack of nearby healthcare facilities means that basic health problems, or even pregnancy, often lead to weakness, frailty, suffering, and death.

Sick person taken to Hospital on stretcher, on foot. Zambulkura 2015

Health screenings and building a school

In July 2018, we started building a school in Zambulkua and enrolled 235 of the younger children. In the two calendar years of building, from mid-2018 to mid-2020, 10 of the school children died from malaria (4.26%). To bring these numbers down and improve health throughout the region, we have performed annual health screenings for four consecutive years now, reaching 1-2000 people per screening.

During the ‘malaria season’ when the rain starts, 8-9 out of 10 children contract malaria. That is about 80-90%. Approximately 5% of children in the area are malnourished and stunted in growth, making them extra vulnerable to malaria. The illness often results in anemia and decreased learning capacity. In addition, other infectious diseases such as leprosy, which is contagious, has been identified during the last health screening carried out in Zambulkura in November 2020.

The effect of all these issues, is depletion of resources at all levels (individual, in the family, and the community), and the impact on learning capacity due to anemia and intellectual exhaustion is severe.

Teachings have started in school, Zambulkura 2018

Part of holistic development project

Building a healthcare facility for these villages, in the East Mamprusi district, is part of an ongoing area development in a hitherto deprived community, with 95-98% rates of illiteracy among the adults. The community leaves very small environmental footprints, but the lifestyle frustrates the young, many of whom leave for perceived greener pastures, either for the larger cities where they become urban poor, or migrating towards the trans-Saharan route to Europe, with inherent risks and broken dreams.

Due to illiteracy it is increasingly important to have a health facility and a health professional in the local community (Medical Assistant/Nurse/midwife), as these communities are severely incapacitated with respect to educating themselves via online options - they are simply cut off from communication with the wider world, due to illiteracy and language barriers.

The healthcare facility - a two consultation-room clinic

The establishment of a healthcare facility is urgent. Early diagnosis and treatment of malaria and other infectious diseases is needed, as is treatment facilities for minor injuries and reproductive health. The facility will be built step-by-step, as funding becomes available, with options to expand later on.

The health facility will be build step-by-step, as funding becomes available.

We need raise funding for the following steps forward

1.Basic health facility building, 2 rooms,40-45 m2 + porch: 47.864 Ghana Cedis/8168 USD/6.121GBP

2.Toilet and bath: 14.500 Ghana Cedis/ 2474 USD/ 1.854 GBP

3. Water supply (borehole, polytank, stand for tank, works, will also supply the school-garden and womens-development-area with water):
42.240 Ghana Cedis / 7.191 USD/ 5.389 GBP

4. Residence for health professional (2 rooms/kitchen/bath):
53.864 Ghana Cedis / 9.192 USD / 6.888 GBP

Functions of the healthcare clinic

As soon as the basic structure is established, the health clinic will start work, focusing on the following core tasks:

• Providing health education on the prevention of malaria and other infectious diseases by teaching and supervising on the use of mosquito nets, specially for children and pregnant women (mosquito nets alone can reduce malaria mortality rates by 50 %),
• Easy access to testing and treatment for malaria for all villagers, though most critical for children and pregnant women,
• Generate general health awareness (and necessary monitoring) of common health and educational issues as iron deficiency, malnutrition, immunity, vitamin D/ sunshine, general health and nutrition and hydration in the elderly,
• Educate and monitor reproductive health, pregnancy, birth, breastfeeding practices,
• Act as a first-line-emergency facility for minor injuries and snake bites,
• Evaluation of more severe problems and injuries needing referral to hospital in Nalerigu.

Donations of furniture is in the pipeline from Europe and donations/purchase of medical equipment for the clinic and basic medicines will come when the building is in progress. For health professionals, there are several well-educated Medical Assistants, nurses, midwifes and doctors in Ghana, who can be engaged to step in when the clinic is ready.

Previous activities

In order to tackle the problems affecting the people in Zambulkura and neighboring communities, we are progressing along the following lines; always rooted in the communities and the needs they express themselves:

• Environmental restoration: 118 acres of land with native trees, medicinal plants and wildlife, another 120 acres to be planted with cash-crop-trees (Moringa for seeds, grafted shea and cashew, possibly dawadawa for medicinal purposes). This is both an environmental-restoration- process and a “training in democracy”, as if anyone need wood from the area, the matter have to be brought up in a community-meeting for exact approval. Un-approved cutting of wood in this area, carries a fine.
• Building of school, started 2018: 3 classrooms are functioning, approx. 200 children enrolled and there is a 3- person teachers residence, plus a storage room established.
• School feeding: 11 acres of land is cultivated for the school with maize, beans and groundnuts for school-feeding. Children get one good meal per day, when in school. To be expanded with chicken and more vegetables, as well as education about sustainable practices and sufficient and healthy meals.
• Womens rights-and development project, in the pipeline. The Mamprusi-culture, have traditionally lacked in rights and opportunities for women, so educating women, acquiring certain skills for growing cash-crops, handicraft etc, is much needed.
  
• Bee-hives for pollination and cash
  
  

This work is an ongoing area-development in a hitherto deprived community, with 95-98 % rates of illiteracy among the adults. It is a lifestyle that leaves very small environmental footprints, but at the same time frustrates the youth, of which some leaves for perceived greener pastures, either in the larger cities becoming urban-poor, or migrating towards the trans-Saharan route to Europe, with inherent risks, broken dreams and loss of lives.

This model for sustainable change rooted in African Cultural heritage, is called ubuntu. Often shortened to
“I am because we are”- describing our mutual inter-dependence.