My trip to Ghana - Day 5
The day began with a meeting with Dr Agatha Aboe from International Trachoma Initiative (ITI), Philip Downs from The Carter Centre and Dr Maria Hagan, the Head of Eye Care Unit, Ghana Health Service at the WARO offices.
ITI work in the Northern and Upper West regions, where trachoma is known to be prevalent. As there is no full survey of Ghana it is not known whether trachoma exists elsewhere, but they were pleased to hear that we are considering a survey of Upper East region which would at least give a clearer idea of the situation.
The aim is to declare Ghana free of trachoma by 2010. There is currently a backlog of about 9,000 trichiasis operations, but the distribution of azithromycin (an antibiotic) has reduced the incidence of new cases.
We discussed whether there were any ways in which we could cooperate. There’s no scope for co-distribution of azithromycin and mectizan, partly because the Ghana Health Service only allows antibiotics to be distributed by health workers, not volunteers. Also partly because - according to Dr Hagan – there’s no knowledge as to whether the two drugs might interact, so they’re never given together. However, it was thought that training of ophthalmic nurses in particular could be integrated.
Philip Downs was focused on latrine construction, i.e the Facial Cleanliness & Environment part of the trachoma strategy, although the initial driver for the Carter Centre’s work on this had been to reduce incidence of Guinea Worm. There was concern that the emphasis has been placed more on the provision of water and less on sanitation.
Tuesday, June 20, 2006
Wednesday, June 14, 2006
My Trip to Ghana - Day 4 (part 2)
We went on to visit an outreach clinic being run by the ‘John Wilson Optical Centre’, which in turn is run by the EP (Episcopalian Presbyterian) Church. The optometrist and ophthalmic nurse were both very keen, but there is clearly a major problem with this project. It was originally conceived some years ago to raise funds for the rehabilitation project that EP church also ran. The assumption was that it could sell glasses for a profit which could fund the rehabilitation work. The problem is that the area in which it operates is very poor, and the people cannot pay enough for the glasses for the centre to break even - let alone make a profit.
We went on to visit the eyecare centre at the hospital, where we sponsor an eye clinic. The hospital was also seeking a lot more support from us (as was everyone), although I had to smile at the request from the ophthalmic nurses that they should be sent on courses in the UK. I asked whether there were no equivalent courses in Ghana or neighbouring countries. ‘But we would like to visit the UK’ they said. Am I just being suspicious in thinking these are young people who are hoping to find work in the NHS? Ghana is littered with posters from banks advertising how to send money from abroad, and the pictures on them are mainly of nurses. Needless to say we didn’t agree to this request. I gather that the problem of the brain drain hasn’t affected ophthalmology particularly badly in Ghana, not least because the ophthalmic nursing qualification that we sponsor isn’t recognised in the UK.
Whilst at the hospital we called briefly on Dr Awade, the Director of the Onchocerciasis Research Centre which happens to be based there. Dr Awade is doing research on new drugs for oncho (river blindness), which have a much longer half life in the body than mectizan and will hence be more effective – possibly meaning that it will no longer be necessary to provide drugs every year for at least twenty years.
From here we travelled back to Accra for a welcome early night.
We went on to visit an outreach clinic being run by the ‘John Wilson Optical Centre’, which in turn is run by the EP (Episcopalian Presbyterian) Church. The optometrist and ophthalmic nurse were both very keen, but there is clearly a major problem with this project. It was originally conceived some years ago to raise funds for the rehabilitation project that EP church also ran. The assumption was that it could sell glasses for a profit which could fund the rehabilitation work. The problem is that the area in which it operates is very poor, and the people cannot pay enough for the glasses for the centre to break even - let alone make a profit.
We went on to visit the eyecare centre at the hospital, where we sponsor an eye clinic. The hospital was also seeking a lot more support from us (as was everyone), although I had to smile at the request from the ophthalmic nurses that they should be sent on courses in the UK. I asked whether there were no equivalent courses in Ghana or neighbouring countries. ‘But we would like to visit the UK’ they said. Am I just being suspicious in thinking these are young people who are hoping to find work in the NHS? Ghana is littered with posters from banks advertising how to send money from abroad, and the pictures on them are mainly of nurses. Needless to say we didn’t agree to this request. I gather that the problem of the brain drain hasn’t affected ophthalmology particularly badly in Ghana, not least because the ophthalmic nursing qualification that we sponsor isn’t recognised in the UK.
Whilst at the hospital we called briefly on Dr Awade, the Director of the Onchocerciasis Research Centre which happens to be based there. Dr Awade is doing research on new drugs for oncho (river blindness), which have a much longer half life in the body than mectizan and will hence be more effective – possibly meaning that it will no longer be necessary to provide drugs every year for at least twenty years.
From here we travelled back to Accra for a welcome early night.
Friday, June 09, 2006
My Trip to Ghana - Day 4 (part 1)
We travelled to Hohoe. Here we support an integrated education project, but the timing of my visit coincided with schools being closed other than for those taking public exams. So we visited a local orphanage where two of the children are blind and are supported by Sightsavers.
This was perhaps the most emotionally wrenching experience of the trip. The orphanage, run by Pastor Issa Anaabi and his wife, wins medals for its choir and they sang a range of gospel songs for us, including a rendition of ‘By the rivers of Babylon’ (infinitely superior to the Boney M version (for those old enough to remember!)). We spoke to the two children, Grace (17) and Michael (10). Grace had a beautiful voice and was clearly very bright. In answer to my question ‘what do you want to do when you leave school’ she replied ‘I want to be a journalist’. I asked if she could sing ‘Amazing Grace’, given her name. Of course I had forgotten the words until she got to them ‘I was blind but now I see’. I don’t know how I kept back the tears.
Michael was a much less optimistic story. He was blinded by his mother taking traditional herbs during pregnancy in an effort to abort him. She abandoned him when he was born blind, leaving him with his father and a new step mother. They were so ashamed of him they shut him in a room for several years, until someone mentioned the orphanage, so they took him there and abandoned him. He was clearly an emotionally damaged child (unsurprisingly), although he could write his name in Braille and knew his alphabet. He would clearly be loved and protected at the orphanage, but I found it hard to be overly optimistic about his long term future.
Finally, we visited Ivy, 10 yrs old, at her home. She has progressively deteriorating sight, and is expected to become totally blind so is now moving to Braille. The project workers and her mother said that she had a low IQ, yet when they showed me her exercise books, her maths was actually very good (although her English was poor). I was concerned that this was an example of a child who can’t see and hence finds it difficult to learn at school; the result being that they’re ever afterwards wrongly labelled ‘unintelligent’.
We travelled to Hohoe. Here we support an integrated education project, but the timing of my visit coincided with schools being closed other than for those taking public exams. So we visited a local orphanage where two of the children are blind and are supported by Sightsavers.
This was perhaps the most emotionally wrenching experience of the trip. The orphanage, run by Pastor Issa Anaabi and his wife, wins medals for its choir and they sang a range of gospel songs for us, including a rendition of ‘By the rivers of Babylon’ (infinitely superior to the Boney M version (for those old enough to remember!)). We spoke to the two children, Grace (17) and Michael (10). Grace had a beautiful voice and was clearly very bright. In answer to my question ‘what do you want to do when you leave school’ she replied ‘I want to be a journalist’. I asked if she could sing ‘Amazing Grace’, given her name. Of course I had forgotten the words until she got to them ‘I was blind but now I see’. I don’t know how I kept back the tears.
Michael was a much less optimistic story. He was blinded by his mother taking traditional herbs during pregnancy in an effort to abort him. She abandoned him when he was born blind, leaving him with his father and a new step mother. They were so ashamed of him they shut him in a room for several years, until someone mentioned the orphanage, so they took him there and abandoned him. He was clearly an emotionally damaged child (unsurprisingly), although he could write his name in Braille and knew his alphabet. He would clearly be loved and protected at the orphanage, but I found it hard to be overly optimistic about his long term future.
Finally, we visited Ivy, 10 yrs old, at her home. She has progressively deteriorating sight, and is expected to become totally blind so is now moving to Braille. The project workers and her mother said that she had a low IQ, yet when they showed me her exercise books, her maths was actually very good (although her English was poor). I was concerned that this was an example of a child who can’t see and hence finds it difficult to learn at school; the result being that they’re ever afterwards wrongly labelled ‘unintelligent’.
Friday, June 02, 2006
My trip to Ghana - Day 3
Today, we travelled to visit another rehabilitation project at Krachi, which is clearly very well run. The issues were similar to those at Bolgatanga, but they have also managed to get some financing from the local District Assembly to help support the project. They are planning to use a boat - from the Assembly - to access the many islands on Lake Volta, which have never enjoyed any rehabilitation services.
They estimate their backlog of patients for cataract surgery at about 200 and a waiting time of about a year for rehabilitation. They are cooperating with the District Assembly in pulling together a register of disabled people, including the nature and cause of their disabilities. Leafing through this, the overwhelmingly dominant cause of irreversible blindness is glaucoma, which is something we need to try and get a grip on in the future.
The main problem here is with a lack of vehicles – we offered to replace one of their two motor bikes which had irretrievably broken down. It was also mentioned was that some of the clients had a problem with microfinance as they had become accustomed to handouts and didn’t understand that they actually had to repay the loans.
We crossed Lake Volta (the biggest man-made lake in the world) via plantoon to reach Nkwanta, where we’re staying overnight. There were beautiful views over the lake at sunset, but these were marred somewhat by thoughts of the number of people on the register of disabled who had been blinded by ‘spitting snakes’!
Today, we travelled to visit another rehabilitation project at Krachi, which is clearly very well run. The issues were similar to those at Bolgatanga, but they have also managed to get some financing from the local District Assembly to help support the project. They are planning to use a boat - from the Assembly - to access the many islands on Lake Volta, which have never enjoyed any rehabilitation services.
They estimate their backlog of patients for cataract surgery at about 200 and a waiting time of about a year for rehabilitation. They are cooperating with the District Assembly in pulling together a register of disabled people, including the nature and cause of their disabilities. Leafing through this, the overwhelmingly dominant cause of irreversible blindness is glaucoma, which is something we need to try and get a grip on in the future.
The main problem here is with a lack of vehicles – we offered to replace one of their two motor bikes which had irretrievably broken down. It was also mentioned was that some of the clients had a problem with microfinance as they had become accustomed to handouts and didn’t understand that they actually had to repay the loans.
We crossed Lake Volta (the biggest man-made lake in the world) via plantoon to reach Nkwanta, where we’re staying overnight. There were beautiful views over the lake at sunset, but these were marred somewhat by thoughts of the number of people on the register of disabled who had been blinded by ‘spitting snakes’!
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