Bolga: Day 1

I'm writing from my hotel room in Bolgatanga, with the Brazil v. Cote d'Ivoire match on in the background. It's become a sort of routine for me here, watching soc--I mean, football every day. More on the always interesting World Cup--and the antics it inspires in its loyal aficionados--later. Anyway, I'm here in Bolga, which is in the Upper East Region, to observe firsthand the work Catholic Relief Services (CRS) does in rural communities. I visited the CRS office in Tamale last week where I was able to learn about 2 projects the organization is undertaking in developing rural communities in Ghana: CIMACS and SILC. (CRS really loves its acronyms...)

CIMACS, which stands for Community Initiative on Maternal, Child, and Newborn Survival is a 3-year program begun in 2009 to reduce maternal and child mortality in the Upper East Region of Ghana, where communities are especially susceptible to high mortality rates. CRS works with Ghana Health Services which nominates high-risk communities. A needs assessment is conducted to ascertain the things the communities lack, like roads, water, better farming tools, and money for starting businesses. CRS gathers at least half of the community and takes a vote; if the community decides as a whole that its most pressing need is health, the community is chosen.

I'll highlight just a couple of aspects that I found particularly interesting about CIMACS. CRS employs the "Positive Deviant" strategy, which identifies the few people in the community whose behaviors are seen as deviant by other members, but in reality are positive. In this case, it would be delivering a baby at a clinic instead of in the home--the traditional method. This also includes the concept of breastfeeding. Many locals think that breast milk is bad, and give newborns cow's milk instead, but breast milk is the ideal choice because it provides essential nutrients that help strengthen a baby's immune system, which is crucial. CIMACS promotes "immediate and exclusive breastfeeding" for up to 6 months. Also, traditional birth attendants (TBAs) are given items as incentives for them to give up their job of delivering babies in the home, and become link providers, essentially "linking" expectant mothers to the clinics. CRS gives TBAs items such as motorbikes, raincoats, and rain boots to make it easier for them to transport expectant mothers to the clinic, where it is both cleaner and safer, and ensures a healthy delivery.

The other project is SILC, Savings and Internal Lending Communities, which provides a way for members of the community to pool their money together in a safe place. SILC integrates with CIMACS by financing the items given to the link providers. A group consists of ~25 members that meets weekly. The money is collected and kept in a box that has 3 padlocks. One person keeps the box, and 3 people keep the keys for the 3 different padlocks. These four people are scattered throughout the community. I think this is a pretty cool way to protect against theft and instill a sort of connectedness among the group. Money is set aside for special things, like social and savings funds. There are fines for lateness to the group meetings, which is put in the box. After 10-12 months of saving, the group "graduates" and the money is shared among the group in proportion to their contribution over the months. Some achievements of this program include providing loans to members who want to start up a small-scale business (ex: selling roasted groundnuts), and even encouraging co-existence among different ethnic groups.

Today consisted of training the data collectors, which number around nine. They're mostly graduate students and those who have experience with researching in the field. Their main task is to translate the CIMACS-SILC baseline survey into the local languages. The questionnaire asks basic questions such as marital status, education level, and becomes even more specific, asking respondents to rank their mode of transportation (donkey, bicycle, motorcycle, etc), how much money they have saved, and about maternal care. This serves as a way to gauge how the community as a whole goes about delivering babies.

Filling out a questionnaire seems straightforward enough, I thought, but the translation of the questions from English to the local language is critical. Each survey will be done orally, given to about 40 members of the community, so extra care must be taken. For example, one question asks "How many people live in your household?" Seems easy enough, right? But the choices are: 1) 5 or less, 2) between 6 and 10, 3) between 11 and 15, 4) between 16 and 20, 5) more than 20. The concept of extended family is important in the culture of Ghana and many African countries, but the question means the nuclear family, or how one person put it, "those who eat from the same pot."

I hope I'll have a lot more to report as I go through the week, but for now...

GOOOOOOOOOOOOOAL!

I can't stress enough how great it is to be in Ghana during the World Cup. Yesterday, we all gathered to watch the Ghana v. Australia match, specially projected on the wall.


Waiting in anticipation as Asamoah Gyan prepares for his penalty kick and....


GOOOOOOOOOOOOOAL! (Please note the annoying vuvuzela, the bugle-like instrument that has been the constant backdrop of all the matches, which sounds even worse in real life).

The song sung after every goal:


And the amazing (????) dancing that takes place. This is from the Ghana v. Serbia match.


This was long. Props to you for making it this far!