December 25, 2007 Greetings from the village of Kongo on our 10th day in Ghana.   One of our goals this trip is to help farmers to increase their yields and better feed their families.  Nearly everyone here farms in the wet season; growing millet, guinea corn and ground nuts.  Though hunger in the dry season has probably always been a problem, due to improvements in health care and lack of family planning, most farmers cannot grow enough to feed their growing families. It was quite distressing to see families get hungrier as the dry season progressed on our last visit.  We have been walking to many of the farms in the area with the intention of finding out what the farmers think would help them most.  Farmers with land in the valleys are able to dig shallow wells, 10-20 feet, and then farm throughout the dry season.  The dry season farmers say their greatest need is for water pumps and fencing.  Though it is hard to believe, there are no fences here.  The wet season farmers build a flimsy barrier of millet stalks and then sleep in their fields to keep out the cows and goats.  These “year round” farmers are the skinniest bunch of men you have ever seen.  Fertilizers and improved seeds (a.k.a. more expensive) would help in the wet season.  We have several meetings within the next week to speak with local officials and an aid agency called “Technoserve” regarding help with framing practices.  Our friends and family may be wondering what Lisa and David know about farming.  A valid point, actually hardly anything at all.  We hope to learn fast and combine our funds and efforts with others that have the technical and agricultural expertise.  Thanks to all of you that donated money and purchased th leather briefcases, I think your money will be put to good use here.  DJ is the only one who has actually worked much on a steady basis so far.  The new priests here are from India, they heave purchased 7 used computers in Accra (the capital of Ghana) and have plans to open a computing center.  DJ is able to give a big boost to this endeavor.  He has managed to get five of the computers operational and is teaching computer classes from 9-12 each morning.  At the insistence of the priests, the cost of class is $3 for two weeks.  Most of his students have finished senior secondary school.  David and I are providing “scholarships” for a few students that cannot afford even that small fee. 

Regarding my work, there is a new certification requirement for physicians from other countries working in Ghana.  Consequently, I am going through some unanticipated bureaucratic processes before beginning work. Lucky for me, one of the priests in the vicinity is having some back problems and may be able to expedite things a bit.  In the meantime, I have helped a little with some prenatal care and have been assisting with paperwork, something I swore to avoid while here!  There is quite a bit the clinic must do for end of year reporting.  There are several changes at the clinic; most significantly testing and treatment for HIV disease.  ART drugs are now available ten miles away at the Bolga hospital.  The cost is about $10/month/person.  All pregnant women are tested for free and trtment is also free during pregnancy.  There is a small charge for others to be tested. I look forward to getting involved with this aspect of care at the clinic.  Another change is the staffing, they have a much needed additional nurse on staff.  Thirdly, all children receive an antimalarial treatment regimen between the ages of 3 months and 2 years. The nurses report this significantly reduces the cases of malaria in children.


Dec 26


Things are looking up!  I have been approved to work at the clinic for the next 3 months.  I began by helping with the antenatal clinic (prenatal care) this morning and will start seeing chiropractic patients .  next Tuesday.  The midwife, Beatrice, was testing all the pregnant patients for HIV disease today.  The fifth patient, a very thin woman looking about 10 years older than her stated age of 26 yrs, was HIV positive with the blood screening, so a different test was also done.  The patient was positive on both tests.  Both tests involve  drop of blood, collected by sticking a finger tip.  Within 10 minutes of starting the office visit, Beatrice was delivering the news to a 26 year old pregnant woman that she was HIV positive.  It was all done in the local language, so I didn’t follow much of the conversation.  I do know that her medical history includes multiple pregnancies, but only one child is still living.  Beatrice has asked her to come to a meeting of people living with HIV disease; that is where ART treatment will be explained (ART treatment can be started at 28 weeks of pregnancy and greatly reduces the risk of transmission to the baby) and ways to discuss the disease with the family members will be broached.  Though I have not yet seen it, Beatrice says that people that are HIV positive are often stigmatized in the local community.  To complicate things further, she may not be the only wife.  Polygamy is fairly common in all parts of Ghana.  What a challenging situation for this young woman.