Category Archives: IYIP Rights Media Internships

Radio empowers youth in northern Ghana

Voice of the Youth's Prosper Agamboa Adudi

“My studio is so full you could bake a loaf of bread with the heat,” says Awonatey Hippolite, the exuberant host of Voice of the Youth, a new radio show in Sandema, a small town in Ghana’s impoverished Upper East Region.

On a hot Thursday afternoon a half dozen young Canadians quietly watch Hippolite as he fades in and out of upbeat Ghanaian high-life music between his every phrase. They are volunteers with a charity called Operation Groundswell and are here to see Hippolite’s guests: a panel of four recent high school graduates from the community.

Prosper Agamboa Adudi is the group’s de facto leader. At 24, he is older than his peers by at least five years.

“Poverty is killing us,” Adudi says as a lone microphone squeaks its way toward him. He and his friends are on the air for the second time to discuss issues that are important to them. Today’s topic is drug and alcohol abuse. Adudi goes on to say that some of his friends would “drink themselves out” and describes how serious the problem is in Ghana’s north.

Adudi decided to start Voice of the Youth with his friend Isaac Bukari to empower young people in Sandema and the surrounding region. For today’s roundtable discussion they are joined by Azantilow Awoboro and A. Vida Akan-Yaaminyum.

“We need to get ourselves united as youth,” says Adudi when asked why he started the program. “That’s what brings about development.”

Adudi has been able to book some time each week on Radio Builsa, the region’s local station. “Most people predominantly listen to radio stations [for information],” he says. “We can’t possibly be moving around house by house.”

With that powerful medium he hopes to cover a number of issues important to young people in the Upper East Region. Those topics include unemployment and migration from the north to large cities like Accra and Kumasi.

To tackle both problems Adudi says Sandema’s leaders need to step up and give youth the opportunities they need to start their lives after school. “People who have a lot of experience and have gone far in life should be doing this,” he says. His friends say more work apprenticeships and activities—such as organized sport—are needed to empower local youth.

Adudi has faced his own share of challenges to get where he is today. He says he lost his parents when he was about nine years old but didn’t go into the details. He was later taken in by the Horizons Children’s Centre, a Canadian charity that provides food and shelter to orphans in Sandema, and given the chance to attend school.

“Now I’m done with high school and I’ll be getting myself into university,” Adudi says. But first he wants to give others the same opportunities he was afforded thanks to the Horizons Children’s Centre.

He says young people can wait up to six months to get their results after junior high school. It can also take as long as a year for Ghanaian students to make the transition from senior high school to university. “They can be influenced during this time to do things they wouldn’t do while in school,” says Adudi. “Drinking, smoking and just doing things that would retard their progress.”

Adudi hopes his program can provide a forum for young people to be active in the community and productive during those periods of transition.

Voice of the Youth is still in its infancy but already shows signs of growth. At the end of the first show five listeners called in to discuss topics affecting youth. After the discussion about drug and alcohol abuse that number doubled to 10 callers. If Adudi has his way the response from Sandema’s youth to the program could very well heat up just as much as Radio Builsa’s tiny studio.


Witchcraft forum focuses on gendered solutions

On May 19, the International Institute of Journalism and JHR hosted a community dialogue on the issue of witch craft allegations in Northern Ghana. Twenty IIJ students, members of the Ministry of Women and Children, local media outlets and NGOs debated the role of the media concerning allegations of witchcraft in the North.

Ghana’s Upper East and Northern regions are home to seven witch camps – more than any other region. The largest camp, Gambaga, was established over a century ago and is now home to 83 women and over 45 dependent children and grandchildren.

As guests began their presentations, the bottom line became clear: accusations of witchcraft are based on gender.

“The debate is beyond whether there are witches or not. The issue is that witchcraft allegations have become a feminized issue,” said I.P.S. Zakaria, of the Department of Women and Children.

Women, often elderly and widowed, are accused for misfortunes in their villages, leading to lynching or banishment to camps far from their communities. The banishment of these women directly affects their access to hygienic facilities, education and economic independence. For many women, discrimination and the emotional stigma attached to being accused limit their ability to speak out against the issue.

“When a woman is 30, she will fight the allegations with all her power,” explained Fati Al-Hassan, president of the Anti-Witchcraft Allegations Campaign Coalition (AWACC). “But when she gets into her 50s and 60s, she begins to accept these powers and confess to these allegations.”

Zakaria finds many women are unable to act independently from their husbands, keeping them vulnerable to allegations. Many widows are accused of witchcraft so they are not entitled to their husband’s inheritance.

“If it looks like you killed someone with witchcraft, you are not entitled to the use of the property,” explained Al-Hassan.

She is no stranger to allegations, having been accused of being a witch herself.

“I love my powers,” she said. “I love the assumption that people have that I have these powers, because it gives me motivation to do the work that I do.”

Allegations follow similar trends, says Ken Addae of AWACC. Working with members of the witch camps since 2000, he has found allegations often occur in areas with high poverty levels and low education. The largest indicator is the structure of social and cultural systems that make women vulnerable, said Addae.

However, Al-Hassan finds this no reason for justify the accusations.

“Culture is dynamic,” she said. “We can’t cling to a culture and justify our actions when we abuse someone.”

Journalist Francis Npong echoed Al-Hassan’s concerns, targeting the media as those most responsible for influencing public opinion on the issues.

“The world is changing,” said Npong. “The role of the media or journalists now goes beyond just the traditional role of informing, educating and entertaining …This century needs more dedicated journalists than any other century.”

Panelists encouraged journalists to make their messages accessible to communities most likely to banish women for witchcraft. Addae suggested creatively engaging communities with traditional Dogon drum and drama troops to shift public opinion.

Addressing the crowded room of students, panelists encouraged the audience to be assertive and balanced with their reporting. They also emphasized the importance of minimizing harm.

A journalist herself, Al-Hassan envisions the media as the public face of the fight for human rights awareness.

“When people have rights, they must be made to see that they are working for them,” she explained.

The forum topic was chosen by the students themselves who have shown an interest in addressing and educating themselves on issues specific to their region.

Talking to the students, the impact of the forum is obvious.

“I have learned so much on how to report gender issues and women’s rights,” said Yakubu Gafaru, the JHR vice-president. “It was interesting to see the majority of the camps are within our region. Why not down south? It means there is something behind it, something we need to address.”

Others found the chance to work with prominent female journalists inspiring.

“We need more female role models like Madam Fati [Al-Hassan],” explained Yahaya Niamatu. “I admire the courage she has. I want to be just like her.”

“Meating” halfway – The growing importance of soy in Malawi

Skewered meat sizzles on kickstand grills along the main M1 highway, a whole pig is slaughtered in an open-air butcher’s market shack, a farmer herds wealth-representative cattle down a maize-sidled byway and a “road runner” free range chicken dodges potholes and traffic – in a culture where cows have long symbolized status, slaughtered to honour guests and in the north traded as a dowry to marry off daughters, making the conscious choice to live a vegetarian lifestyle in Malawi is about as rare as an order of steak tartare.

But a Development Aid from People to People in Malawi (DAPP in Malawi) program is working to change the mindset and the menu.  In 2007, with support from the United States Department of Agriculture, the American Soya Bean Association and the World Initiative for Soy in Human Health, DAPP in Malawi began training Total Control of the Epidemic (TCE) field officers to promote soy in communities affected by HIV/AIDS.  Today over 100 of their HIV/AIDS support groups have been trained to cultivate and cook with soy in the preparation of other local foods.

Recipes promoted through the DAPP – TCE soya program include banana and soy sausage, masamba a soya (soy vegetables), khofi wa soya (soy coffee), and mkaka wa soya (soy milk), and are made available on print paper with easy-to-follow directions; “Boil 3 cups water, wash (1 cup of) soya in cold water, don’t put the soya into the hot water all at once but little by little like you do with rice,” begins the soy milk instructions.

Goliyati Village resident Mary Bilila serves up a selection of newly-mastered soy recipes during a DAPP - TCE HIV/AIDS support group meeting. Photo by Karissa Gall.

Based on the nutritional value of 1 cup of boiled soybeans, the DAPP – TCE soy milk recipe would provide about 300 calories, 28 grams of protein, 10 grams of fiber, and 20 grams of fat.  The soy milk would also provide essential vitamins and minerals, with 1 cup of boiled soybeans providing 50 percent of the recommended daily intake of iron, 40 percent of the recommended daily intake of vitamin D-balancing phosphorus, and 4 percent of the recommended daily intake of vitamin C.

According to DAPP in Malawi Partnership Officer Nozipho Tembo, the nutritional benefits of soy foods could make a substantial difference in the fight against HIV/AIDS.  The disease is known for causing micronutrient deficiencies – vitamin A, vitamin B12, vitamin C, vitamin D, carotenoids, selenium, and iron in the blood – which in turn speed the progress of the infection, and in 2006 a study conducted by Médecins sans Frontières in Malawi found that patients with mild malnutrition were twice as likely to die in the first three months of treatment, and patients with severe malnutrition were six times as likely to die as patients with a healthy body weight.

“Over the years we have learnt that soya is high in proteins which can be substituted for meat, cheese and fish, of which some people in rural areas can’t afford to have on their daily meal,” said Tembo, adding that 1 kg of soya costs MK200 (CAD0.80) compared to MK800 (CAD3.00) for 1 kg of meat.  “The DAPP – TCE project teaches the communities to adhere to a well-balanced diet and this is one way for people in rural areas to get proteins in their meals.”

To support existing programming and expand into other areas of Malawi, Tembo said DAPP in Malawi and TCE will be engaging seed companies for seed donations.

“The demand is high… the people who are (HIV) positive are living a healthier life whenever they adhere to the information given to them about soya and how to prepare it,” she said.  “Now the challenge will be to provide soya seed for the people to plant in their fields.”

Remodel to rehabilitate – The need for mental health aftercare and rehabilitation treatment in Malawi

A build or remodel is not typically what the doctor ordered to stave off chronic stress and depression; the process risks construction anxiety and expense and according to Walter A. Brakkelmans, an associate clinical professor of psychiatry at UCLA, “on a scale of 1 to 10, 10 being the death of a child and 1 a fender-bender, a remodel rates a 6 in terms of stress.”

But in Malawi there is a shortage of doctors with orders, and for Flomina Mawindo, a single mother of five in Che Mboma village, rebuilding a dilapidated house is her best shot at ensuring her own rehabilitation to home life after being discharged from Zomba Mental Hospital.

Mawindo was admitted to Zomba Mental Hospital after familial and financial stresses set off a downward spiral into anxiety, insomnia and ultimately mental illness – she struggled with a husband who, until his death in 2004, encouraged thieves to steal from her to ensure she did not have the means to divorce him, in-laws who cursed her and her children and a son who stole from other villagers and skipped town leaving her to answer to the authorities and pay outstanding debts.

She began walking the streets at night, talking to herself and became increasingly violent when her children attempted to restrain her, and after initially being turned away from the Queen Elizabeth Central Hospital primary health care facility in Blantyre was admitted to the mental hospital in November of 2011.  She was discharged in February of 2012, and is able to recall, with a shaking voice and haunted eyes, her experience at the hospital as one of “trouble and pain.”

“In the first ward, it was not good at all,” Mawindo remembers.  “There were four or five patients in one room.  The others would bite me, abuse me, and grab my food.  I could not protect myself.”

Mawindo said the problems that made the hospital “like a prison” were caused by a shortage of doctors and nurses, an issue that was confirmed by a nurse at the hospital who said “the nurses are always there, but for example today we are only two nurses, and we have got 53 patients… For one or two nurses to look after 50 patients and provide the quality of care that they need?   It’s impossible.”

Due to the shortage of doctors and nurses, psychological treatment has not been institutionalized and instead the provision of drugs takes priority.

Mawindo has been prescribed sodium valproate, a mood stabilizer which causes side effects which include fatigue, shaking and sedation and are immediately obvious in Mawindo.  She is no longer strong enough to walk to the market to do business and has not returned to work since being discharged.  Her eldest daughter Tadala absconded from primary school to care for the family until the Jacaranda School for Orphans stepped in and hired a caretaker.

Beyond the caretaker and maize meal donations provided by Jacaranda, Mawindo said she is not aware of any community-based services to help support her and her family.


In the absence of government-funded community-based aftercare and rehabilitation services, Mawindo said she plans to make repairs to a dilapidated house on her property and open it to renters or turn it into a chicken farm.  She said with the supplementary income she will feel less stress about paying debts and providing food for her family.


She derives her motivation from the time spent at the mental hospital – not from therapy and positive learning but the fear of return.

“I was going through trouble and pain at that hospital,” she said.  “I’ve decided I will never go back there again.”


According to Draft III of the Malawi Health Sector Strategic Plan for 2011-2016, in March of 2011 when the plan was published there were no mental health activities at community level, primary health care units did not provide mental health services, the treatment services provided by tertiary institutions were mainly for people with severe or acute mental health problems and the provision of psychological rehabilitation was limited.

The same report found that in 2011 only 1.5 percent of the national health budget was being spent on mental health and except for one or two districts, most districts spent none of their budget on mental health services apart from the procurement of drugs.

Understanding the link between gender and climate change

A common sight in Malawi: Young girls carry heavy loads of firewood. Photo by Desiree Buitenbos

When I met 16-year-old Chikondi Phiri, she was struggling to lift a weighty load of firewood on top of her head. I offered her a helping hand, and initiated a conversation about why she was carrying the wood in the first place.

“It’s for my family,” she said proudly.

I could hardly hide the perplexity on my face. Chikondi’s slender frame and youthful appearance had me questioning what sort of family would make such a slight girl perform such a laborious mission?

Sweat poured from Chikondi’s brow as we attempted to lift a heavy bunch of branches in scorching heat, and when the task was completed, she walked off with the balance of a high-wire artist, and said, “See you”.

In Malawi, I see girls like Chikondi all the time. They’re usually either collecting water from a polluted river or carrying wood with babies bouncing on their backs.

According to the United Nations, women in sub-Saharan Africa spend 40 billion hours every year collecting water and up to 9 hours a day collecting firewood. Not only do the latter play a huge role in contributing to the 41 million girls’ worldwide not attending school; but also it is one of the many reasons why African women will likely be hardest hit by the impact of climate change.

My interest in understanding the link between gender and climate change in Malawi took me from Lilongwe to Kasungu, a northern rural town, where rainfalls have become increasingly far apart. In 2002, over 100 residents died in a famine brought on by drought, and the community has been picking up the pieces ever since.

On a visit to Nkhamenya Girls Secondary School,  I spoke to a group of students about their daily “female” chores and what they knew about climate change. Many said the temperatures continued to drop over the years, forcing more girls out in search of wood to heat up their homes. Others said they knew children who had died due to smoke inhalation. In fact, worldwide, pollution in homes caused by burning wood kills about two million women and children a year.

Sitting there, listening to these stories, I couldn’t help but feel an overwhelming sense of guilt when one girl asked me, “What is causing this climate change?”

I took a second to gather my thoughts before saying,

“Well, climate change is caused by human action, more specifically, the burning of fossil fuels which contribute to global warming – the heating of the Earth’s temperature.”

They just stared blankly. I knew I had to define it on more simple terms.

“You know those big cars that people drive here in Malawi?” I said, “Those cars burn poisonous gases which make the Earth hotter. You know those big factories with black smoke coming out of them? It’s the same thing.”

I further expanded on the greenhouse effect, and they seemed to get it. But trying to define climate change to Malawian school girls was like trying to paint a picture of hyper-industrialization in a country where vast, barren landscapes and an indigenous way of life are the norm.

Climate change is a condition not of Malawi’s creation – less than 0.1 metric tons per capita of carbon emissions, while Canada contributes 16.3 metric tons. Yet there are NGO’s working in Malawi who are promoting an idea that locals are somehow responsible. They implement projects to plants trees, and raise awareness about the issue. But where are the solutions?

The NGO focus on climate change in developing countries should not be on deflecting the problem, but rather figuring out ways for locals to cope with the change.  Farmers will benefit more from learning to adapt to the temperamental weather, while girls would benefit from a cleaner energy source which would not involve collecting firewood.

As I left the school, I realized the weight and the importance of my visit.

To see a different perspective is the very reason we travel, we explore, and meet people like Chikondi who inspire us to comprehend a new outlook of the places we come from and the things we do.

Firsthand research and experience with the Malawian health care system

“Take a deep breath. Another one, and one more…”

Those were the last words I heard before I couldn’t fight the anesthetic anymore and I was fast asleep.

I recall questioning whether this was really happening. It was just a couple weeks prior that I began working on an article that explored the capacity of Malawian hospitals to accommodate serious illness and medical procedures. So far my findings had not been encouraging, so I had the worst of thoughts running through my head as I was being rolled into the operating room.

In one particular interview with a medical intern, I was told that it is not common for most hospitals to have back up generators. If a power outage occurs, there is a chance that patients who rely on the use of power-driven machinery may not be able to survive. Knowing this alongside my other worries, I was deeply afraid of how successful the surgery would be.

When I woke up, the pain in my torso hit me immediately, as the nurses told me it would. It was so widespread I couldn’t detect the precise location of the incision.

I knew one thing was for sure: my appendix was no longer inside me. It was sitting in a jar, in front of me, labeled “Mara Silvestri, Room 9A” as if it was considered just another body part by those who removed it. For me, it was monumental.

Just hours before, I learned I had appendicitis. Within a five hour span, I was diagnosed and under the knife, without much time to consider my health care options because appendicitis needs to be treated immediately in order to avoid a burst appendix.

As someone who squirms at the thought of blood or needles, I had faced my biggest fear by undergoing an emergency appendectomy. The appendix that sat in front of me symbolized a triumph.

Lying in the hospital bed with my expat crew surrounding me, the first thing I wanted to do was look down to see the size of my scar, but even with remnants of anesthesia clouding my judgment, I knew I wasn’t brave enough to see it.

I couldn’t help being curious. Despite the tears flowing down my face pre-surgery, the doctor was candid with me and refrained from sugar-coating the situation.

“If the appendix has perforated and caused internal problems, we will need to operate further. I’m going to make the scar below your belly button instead of to the side so we can expand it upward accordingly, in case we open you up and find internal problems,” he said  as he motioned his hand up his chest and to his chin.

All I could imagine before surgery was coming out with a scar that spanned the length of my upper body.

I was lucky, I had the appendectomy before any serious complications occurred and the scar is only two inches long, I’m told (I still haven’t looked beneath the bandage).

Prior to that day I had met with multiple doctors who all told me the problem was my kidney. At that point, kidney complications seemed like a relief to liver, gall bladder or appendix complications. After asking around to gain knowledge of who the more experienced doctors in town were, I sought another medical opinion. I was told the problem was indeed my appendix, but by that point the diagnosis was becoming easier to make as the pain I was experiencing was increasing and I was in agony.

“Don’t worry, God is with you” I was told over and over again by doctors, radiologists and fellow patients.

How could I not be worried? My family was tens of thousands of miles away and I have a history of breaking into tears at the slightest of medical worries. I bawled when my dentist informed me I needed my wisdom teeth taken out- and that was at a clinic that was fully equipped, being performed by a doctor I had known since my adult teeth first grew in.

To sit in a hospital bed under a malaria net, with some of Malawi’s most common critters under the covers with me (cockroaches), being served a meal that I am sure consisted of chicken feet, caused me to be very concerned about how my recovery would progress. At one point, the nurse spotted the critter that was crawling about my bed and said “looks like you are not alone!” but this wasn’t the company I envisioned at my bed side.

Furthermore, the hospital I was in does not possess an internal communication system between rooms. There was no button for me to click in order to notify the nurses I needed their attention. The only thing remotely close to that was the radio behind my bed, which fell out of the wall when we tried to use it. This is one of the reasons I was so grateful to have friends I had made here by my bedside.

My stay in the hospital, and my experience with the Malawian health care system made me appreciate the access that patients in countries such as Canada have to a variety of specialists, surgeons, general practitioners and medical facilities.

The hospital I was at was a private hospital in Blantyre, yet it was still under staffed. There were times when I needed my IV changed, required assistance getting out of my bed, or needed another painkiller injection, but nurses told me they were busy with other patients.

I had a great support system to care for me in the days leading up to my dad’s arrival, but I was very happy to have a comfort of home at my bedside as my father walked into my recovery room and greeted me by telling me that he was there to care for me for the next week.

This experience marked an extreme moment in my internship that was already defined by extraordinary moments. Some may call me crazy for not racing back to the comforts of home at a time like this, but even in my post-op state, I’m eager to recover quicker so I can walk around Blantyre again and hear “hey sister” being yelled in my direction on my way to work. I’m also looking forward to once again hearing the sounds of my coworkers greeting me good morning at the beginning of another adventurous work day. It is all part of Malawi’s charm.

And with this, I can safely say that when in Malawi, expect the unexpected.

Ghanaian journalist lectures JHR chapter about rights media

Francis Npong speaks at the jhr-IIJ media forum

Photo by Robin McGeough

On May 19, the JHR chapter at Tamale’s International Institute of Journalism hosted a community forum about witchcamps.

Among the speakers was human rights journalist Francis Npong, the northern correspondent for The Enquirer newspaper. When Npong addressed the students, he gave a solid introduction to rights media in the Northern Region.

Here is an abridged transcript of his speech. For un-edited audio, listen here.

On choosing a career in journalism

“Now as journalists, if I asked this question: ‘Why are you here? Why do you want to be a journalist?’. If your answer is ‘I want to be rich’, you have chosen [the] wrong profession. I am telling you. If you say ‘I want to be loved by everybody, because journalists are supposed to be popular’, this is the wrong profession or the wrong idea … You are not supposed to be loved by any other person or to be rich. Journalism is … a profession that does reward [financially].”

On journalists’ loyalty

“The journalist[‘s] loyalty, should not be to the state. It should be to individuals and the public. I define my public as the weak, the poor, the sick, the marginalized. Let’s talk about the marginalized; those who do not have any power or the voice to say whatever they feel like saying.”

On the role of journalists in Ghana

“Now, the world is changing. The role of the media or journalists now goes beyond just the traditional role of informing, educating [and ] entertaining. The world needs journalists today more than 30 years ago. This century needs more dedicated journalists than any other century.

Why am I saying all [this]? You can see a lot of things happening… We used to say people didn’t have education, now [someone in] every house somebody has completed [secondary school] and the probability that the person reads or writes is very high.

So why are we still reporting on human rights abuses? And a whole lot of issues that do not speak well of us. That is why there is the need for us to step up [with] our profession, our education to be journalists so we can [correct] the situations that are all over … even within our houses.”

On protecting the identities of survivors of human rights abuses

“People put images of abused children, women or whoever in front [pages] without regard for their dignity… That is very bad. Recently … I published a story on allegations of witches … I put a picture and when you look at it, you will see an image but you cannot see the face. That is an aspect of human rights journalism. You see, you put the picture there and people should not be able to identify the image vividly. Because if I see the woman walking on the road, I’ll say ‘Ah, is that not the woman I saw in the papers?’. So that marginalization will continue.”

On the intentions of journalists

“Society is dynamic. Norms, regulation and rules in society can be changed depending on the activeness of journalists… But we are doing this consciously … in line with professionalism. In journalism, we call it the big five principal. In everything that you do, there must be:

  • The truth
  • Accuracy in what you are doing
  • You must be independent, do not allow yourself to be influenced.
  • In all that you do, you must be fair
  • Commitment to minimize harm in all that you do.

In Rwanda, all the genocide that happened was just [from] the pen of a journalist, who caused that mess … What have you gained from the [genocide]?

In journalism, we are writing, not because of writing’s sake. If you … want to write as a journalist, because you can to write and get a main by-line, forget it! That is not the motive for a journalist … ”

On the dangers of human rights reporting in Tamale

“When I came to Tamale, people asked ‘How can you leave Kumasi … and come to Northern Region to do what, you want to be killed?’. I said no, I want to be part of the change. If there is a change today, I am happy to be part of the change.

In 2004, when were writing issues of corruption, bad governance, women’s rights abuses … For years, I was not sleeping my house. I am telling you, some of us [journalists] survived the storm.
I came here under flying bullets, flying stones and we were there to cover live [events].

It came to a time that I was accused by a police commander … of stealing a document in his office. Look at your safety. How [safe] are you? So it was a bad time to operate as a journalist and human rights journalism was very difficult to practice. But some of did it under a disguise.”

On interviewing survivors of human rights abuse

“You don’t ask silly questions. You must know what you are all about. You must be free to let anything to go through your ears and stay in your mind. But you must be able to sieve it, to be able to make an impact that you want to.

In the witches camp or refugee camp, you will not see them smiling. [So] you should not enter there and start to smile. Look at the mood of the situation and adjust yourself to that mood. Make sure that your lifestyle attracts the person closer to you. If not, they will shy away from you. Those are some of the tricks that when you are going to approach a victimized person you must learn to adopt this style. If not, you will go and you will not come away with the story.

You must build trust between yourself and the victims.

You must never reveal your source of information.”

On gender

“You go to every sector in society and you see that men are on top. And any woman who makes it to the top, they call her a ‘witch’, ‘iron lady’ or a whole lot of names. Do you ever see a man nicknamed like that? No. We are giving our women hell.”

Ghana makes inroads against child mortality

Mothers bringing their children to get vaccinated at the La General Hospital in Accra. Photo by Jamila Akweley Okertchiri.

Ghana has taken a major step toward reducing its under under-five mortality rate with the introduction of two new vaccines for rotavirus and pneumococcal disease, but a UNICEF official in the West-African country says it won’t be enough to  meet the fourth Millennium Development Goal (MDG).

That goal is to reduce the under-five mortality rate by 75 per cent between 1990 and 2015. Currently, 80 children out of 1,000 do not make it past the age of five in Ghana. The country would have to cut that number down to 40 deaths per 1,000 to achieve the fourth MDG.

“Ghana is doing a lot but I don’t think it’s enough,” said Dr. Anirban Chatterjee, UNICEF’s chief of health and nutrition in Ghana. “I think there is definitely scope and need for more improvement.”

Rotavirus and pneumococcal disease are the leading causes of diarrhea and pneumonia in young Ghanaian children. Together they account for close to 25 per cent of under-five mortality and are behind only malaria as the leading causes of child deaths in Ghana.

Ghana has become the first African country to introduce both vaccines at the same time. Both are given to young children before they reach four months of age. The GAVI Alliance, a public-private global health partnership, has helped fund the vaccines, which will be available for free to all Ghanaian children. More than 400,000 Ghanaian children are expected to be immunized against both diseases.

The two new vaccines are expected to prevent 12,000 pneumonia-related deaths and another 10,000 deaths from diarrhea, said Dr. Antwi Adjei, program manager of the expanded program on immunization with the Ghana Health Service.

On April 26, Ghana’s health minister, Alban S. K. Bagbin, said in a press statement that the new vaccines will give Ghana the extra push it needs to meet the fourth MDG by 2015.

But for UNICEF, efforts to improve the nutritional health of children need to happen in concert with vaccinations to reduce the under-five mortality rate. Chatterjee said malnourishment can sometimes double or triple the chances of dying from a condition like diarrhea or pneumonia. “[Malnourished children] are more susceptible to contracting the disease, having the sever forms of the disease and also to dying of the disease,” he said.

Exclusive breastfeeding for the first six months of a child’s life is one way to prevent malnourishment in that crucial period. UNICEF has promoted the practice because it also helps create immunity to early childhood killers like pneumonia and diarrhea.

In Ghana, 63 per cent of children are exclusively breastfed during that period. Many women do not breastfeed their children because they are not aware of the benefits or work in an environment—such as the informal sector—where it is difficult to do so.

Adjei said the Ghana Health Service has regular cooperation between departments such as vaccinations and nutrition. In the second week of May, the Ghana Health Service’s various departments meet for Child Health Promotion Week to develop new strategies and programs related to child health.

One big challenge for the Ghana Health Service will be to reach all children with the rotavirus and pneumococcal disease vaccines. About 87 per cent of children under one in Ghana have been immunized for tuberculosis, poliomyelitis, tetanus, hepatitis B, measles and several other childhood diseases. Reaching the last 13 per cent has proven difficult.

“Wherever a person is, we have a responsibility to reach them and vaccinate them,” said Adjei. “Against rising costs it makes it more and more difficult.”

Some isolated communities around Ghana’s Lake Volta, for instance, can only be reached by boat. The Ghana Health Service reaches these small communities at a much greater cost than urban populations.

A small number of Ghanaians also do not take vaccinations due to religious or traditional beliefs. Adjei said the local Twi dialect has only one word for ‘medicine’ that does not differentiate between preventative vaccines and drugs used to treat diseases. He said it is difficult to overcome such beliefs. “Fortunately for us they are isolated cases.”

The new vaccines have just started to roll out across Ghana. La General Hospital, in Accra, was one of the first institutions to offer the vaccines in the capital on Friday, May 4. About 40 mothers were gathered at the hospital with their crying infants in tow, as they waited for their turn for inoculation.

Cynthia Noonu, a nurse at the hospital, said the mothers have been very cooperative. La General Hospital is ready to receive a different group of mothers each week. The vaccines will be rolled out to different hospitals in Accra, and across Ghana, in the coming weeks.

Gladys Otabil was at La General Hospital with her two-month old son Gabriel. “All I understand by the addition of the two vaccines is that they will protect my child from any disease and sicknesses,” she said. Otabil added that she was also advised to breastfeed her son for his first six months of life.

Barriers to mental healthcare in Ghana’s Northern Region

Mami Sandow started hearing voices when she was nine years old.

“She used to roam, talking anyhow, climbing some kind of trees, ” says her brother, Fatawu Sandow. ” You asked her to stop, but she wouldn’t stop. She would just run and hit anything [and fall] down. ”

Mami is 16 years old now and is being treated for epileptic psychosis at Tamale Teaching Hospital She pulls down the left shoulder of her screen-printed dress to show deep scars on the shoulder blade. Her left ear is mangled; the lobe tattered and hanging loosely. Her injuries are self-inflicted; when she hears voices she throws herself at walls to get them to stop.

Seven years ago, when Mami first started exhibiting unusual behaviour, her family thought she was just misbehaving, says Fatawu. The severity of her symptoms increased until they realized she needed medical treatment.

“We thought it was jokes [but] it came to a time, we had to send her to the hospital,” says Fatawu.

Psychiatric drugs in Ghana

Some of the drugs prescribed to psychiatric patients at the Tamale Teaching Hospital.

When Mami first became sick, the family sent her to a hospital in Bolgatanga, about 150 km north of Tamale. A private hospital, her treatment cost over 3,000 GHC ($1,500 CDN). To pay the hospital fees, the family had to sell off property and rely on remittances paid from siblings in Accra.

“We sold everything, just to take care of her,” says Fatawu.

Mami needs around-the-clock attention, to prevent her from injuring herself or others. Fatawu is the sole caregiver, because his mother and father are too busy to help. Staying at home as come at a personal sacrifice to Fatawu.

“It’s even effected my education,” he says. “I was attending [the Tamale Islamic Senior High School] … but because of the sickness, I must come home to take care of her.”

Mami’s epilepsy is treated as a psychiatric illness because of the stigma attached to her behaviour, explains community health nurse David Agyarwa. He says poor understanding of mental health issues stops patients from getting treatment.

“Most people think that when somebody suffers from mental illness it is due to sin an individual committed or the individual is demon possessed,” says the native of Accra.

Agyarwa says there is a great need for psychiatric care in Tamale, yet the hospital does not have a ward. Today he’s conducting interviews in examination room 52; an overcrowded room that houses urological, pediatric and orthopaedic appointments on different days of the week.

“We are compelled to sit at any place [in the hospital] that we can get and do our [patient] history taking,” he says.

Agyarwa says this is problem for psychiatric patients with delicate temperaments. Also, if appointments are conducted in open waiting areas, it violates patient privacy.

The Tamale Teaching Hospital unveiled a new wing on April 30, with maternity, intensive care, neo-natal, radiology and surgical wards, but no provisions for psychiatric care. The $54 million CND building took two years to build and was funded by the Dutch and Ghanaian governments.  Psychiatric patients will be housed somewhere in the new facility, says the hospital’s public relations officer Gabriel Nii Otu Ankrah.

“Because of the importance we attach to psychiatric care, the space will be created for them in the new building, temporarily,” says Ankrah. “[But] the original plan didn’t include space for the psychiatric unit.”

The Ghanian government is prioritizing mental healthcare after the March 2 passage of the country’s Mental Health Bill. The bill promises to de-centralize treatment from the three mental hospitals in southern Ghana, to community hospitals across the country.

Unaware of the government’s new mandate on mental healthcare, Fatawu is simply grateful for his sister’s new course of treatment. Mami hasn’t had a psychotic attack for one week, he says.

“Now it’s good [since] we started coming here, collecting the drugs,” he says. “Now [the illness is] no more [affecting] her, so now she is free.”

How Malawi will remember late president Bingu Wa Mutharika

Bingu Mutharika passed away after suffering cardiac arrest on April 05, 2012

Bingu Wa Mutharika, former president of Malawi, died after suffering cardiac arrest on April 5, 2012. Photo by Desiree Buitenbos

The flag flies at half mast outside Malawi’s parliament building where thousands of civilians have braved long line-ups in smoldering hot sunshine to view the body of late president, Bingu Wa Mutharika, who died after suffering cardiac arrest on April 5, 2012.

To an outsider, this seems like a country truly mourning the loss of their beloved leader. Radio stations and newspapers are bombarded with messages of condolence, while government offices have shut down for the next 30 days.

And though some might argue that the sheer turnout to see Mutharika’s body is evidence of his vast popularity, there are others who say that nothing could be farther from the truth.

Precious Gondwe, 34, has been waiting in a queue to enter parliament for nearly two hours, and her determination to view Mutharika’s embalmed body is fuelled by a desire for closure rather than respect.

“I came here to see with my own eyes that our president is no longer with us,” says Gondwe, “It’s funny that we are lining up to see him when he is the reason we line up for essentials like petrol and sugar.”

Gondwe’s views are not uncommon.

According to Chijere Chirwa, a politics professor at Malawi’s Chancellor College, the lack of mourning among some Malawians can be characterized as “strange” but not unexpected considering the recent failures of Mutharika’s regime to uphold democratic ideals and improve the living conditions for the 74 per cent of the population who survive on less than a $1.25 per day.

“A lot of the critical minds would regard the current economic, social and political situation as developments closely connected with the president,” says Chirwa.

For the past two years, Mutharika, once hailed by the World Bank for his successful fertilizer subsidy program, steered Malawi’s economy into steep decline by telling foreign donors who contribute 40 per cent of the annual budget to “go to hell”.

His dismissal of aid catapulted the government into the adoption of a zero deficit budget which subsequently affirmed that the small landlocked country couldn’t self-sustain with limited resources.

More than 80 per cent of Malawians rely on agriculture for their livelihoods, and tobacco is the country’s main crop, as well as its primary generator of foreign currency. But since 2011, sales of the golden leaf have plummeted by a dismal 57 per cent resulting in reduced finances to purchase fuel from suppliers like Saudi Arabia. This scarcity coupled with a fixed exchange rate has increased consumer inflation to a staggering 10.9 per cent.

According to Voice Mhone, chairperson for the Malawian Civil Society Organizations, the months leading up to Mutharika’s death were overshadowed by rampant dissatisfaction.

“I think the political landscape, as well as the economic situation in Malawi kept on deteriorating,” says Mhone.

“Staying in a queue for fuel is now part of our daily life, and if you look at the price of sugar and other essential commodities they have all skyrocketed.”

On July 20, 2011, the anger and frustration surrounding the country’s economic crisis culminated in mass demonstrations calling for the president’s resignation. These peaceful protests soon turned into bloody riots when police opened fire on innocent crowds leaving 19 people dead and scores of others injured.

But Mutharika didn’t accept blame for the deaths, nor did he take the public criticism to heart; instead he began a vigorous campaign to clampdown on critics, media and opposition leaders.

Reverend Macdonald Sembereka, a civil and human rights activist who played an instrumental role in organizing the protests, had his home petrol bombed by suspected government youth cadets last September. But he says that while the nation has gone through a turbulent time, he has no hard feelings towards Mutharika.

“He did contribute what he could contribute. If he failed that would be part of human nature,” says Sembereka. “I’ll remember him as a person who stuck to his guns. When he wanted to do something, he would stick to it, even though the whole world would stand on the opposite side.”

At Mutharika’s funeral in the southern region of Thyolo, recently inaugurated president, Joyce Banda summed up his life with the sentiment of the nation, saying, “He was not an angel, he made mistakes”.

For Banda, Malawi’s first female president, the road ahead is littered with the legacy of those mistakes, and the latter has prompted her government to resume donor talks with the International Monetary Fund, and the World Bank.