CRHP

Mission Statement Introduction Current Situation Project Objectives Protocol Funding, Finance & Volunteers Links

Sponsors and Supporters Project Locations and Demographics

Mission Statement

This community-based project seeks to initiate the first step in prevention and reduction in infant mortality and morbidity rates in less developed countries. The project involves the collection, production and distribution of basic health related information in the areas of hygiene, nutrition, first aid, immunization and vaccination, pre- and post-natal care to selected rural communities in Ghana. We believe that prevention of diseases and other health-related abnormalities among children in rural communities will improve the economic and social outlook of life. This will ensure that the future generations are protected. Finally, this project is s expected to be self-sufficient in order to expand its coverage area. To achieve financial independence, funds will be solicited from individuals and organizations to help with the production and distribution of our services.

Introduction

The advances in medical sciences in the 20th century have eliminated smallpox, prevented polio and prolonged lives in some ways. Now the populations of developed nations such as the

USA

have never been healthier. Yet emerging developing nations of the world especially those in Africa, bombarded by a myriad of non-health-related national priorities have failed to provide the most basic health services to the populations in the rural communities. Much of rural Africa suffers from inadequate health care infrastructure to planning, coordinating and delivering of the necessary health care services. The Community Rural Health Project is proposed to take the first step in reducing the economic and social cost of this rural problem. It plans to accomplish this by promoting education and training of traditional and non-traditional health-care provider, and promoting awareness of good self-health-care practices through the acquisition and dissemination of health-related information on prenatal and postnatal care, nutrition, hygiene, first aid, immunization and vaccination. The long-term ultimate objective of this unique project is to reduce infant mortality and morbidity among children, and to increase the attendance rate of primary and middle school-age children.

Current Situation and Justification

Health-care services in the cities and urban areas have a wide variety of problems. They range from overcrowding for both out-patient and in-patient, lack of adequately trained staff, old and dilapidated physical facilities, lack of basic clinical essential supplies (drugs, syringes, gloves and disinfectants), and inadvertent lack of concern from the local and the national/central government. So invariably as a means of last resort most rural dwellers in these nations seek health-care services in the large towns and cities, frequently traversing treacherous and impassable roads in their search. Lack of transportation or accessible roads may determine whether the individual lives or dies. Prenatal and postnatal care for mothers and infants are virtually non-existent in the rural areas. Infant mortality is frighteningly high and morbidity of adults and infants is abnormally high. Preventable and treatable infectious diseases are rampant in rural areas. This has resulted in an abysmally low life expectancy rate and astronomically high socio-economic cost to the society as a whole. The irony is that most of these afflictions can be controlled. Control can be accomplished simply by providing the rural folks with certain basic health-care information. Another basic problem afflicting the health-care delivery system in the rural areas is lack of information and coordination of information to help make public health policy decisions to benefit the rural folks. For instance, it is very difficult to get comprehensive information on birth rates, death rates, morbidity reports, prevalence of certain diseases, and information on previous outbreaks of diseases in an area. In developed nations, availability of such information is used in setting public health policy and making planning decisions.

Justification: This project is needed because rural communities are the last group of people to receive any information on health care practices. The only time they hear such information is when they are sick and the local witch doctor/herbalists cannot cure them and they have to go to the local clinic or health post. At this time the health advice provided by the health-care workers may be too late to help the patient. This project is intended to provide health-related information to the rural folks before they get sick, with the hope that they can practice what they have been told. For instance, most childbearing rural women never visit the clinic before, during, or after child- birth unless there is complication and at this time it may be too late, resulting in the death of the infant and/or the mother. Immunization and vaccination for infant and children are never practiced in the rural areas. One reason is that they have never heard about it, therefore children invariably are prone to having infections of all kind with a fatal ending. First aid and hygiene is something rural dwellers do not practice and so lack of such information during minor accidents and emergencies may lead to catastrophic consequence or death of an individual.

Project Objectives

In addition to reasons listed above to support the establishment of this center, availability of such institutions like this dedicated to improving and expanding our knowledge in delivery of health-care information is non-existent. In the third world countries interest in tropical and infectious diseases, and public health-care delivery and maintenance of adequate public health infrastructure is not a to priority. We are also aware of the good intentions of government projects and the realities of implementing such projects, which we need not enumerate in this report. We are, therefore, with this project embarking on (i) Research, (ii) Education and Training, (iii) Information Acquisition and Dissemination and (iv) Public Health Policy Initiatives as our main objectives and mandate.

Research: The center will support and conduct basic research and applied research into the areas of infectious diseases and public health control and prevention programs.

Education and Training: As part of our efforts to help improve the health of our contact communities and that of the population as a whole, the center will organize classes, seminars, symposia and continuing education courses to provide training for health-care providers in area of prevention and education. This will be accomplished in co-operation with local health-care providing institutions. Trainees will include nurses, medical technicians, midwives, traditional and non-traditional birth attendants, nutritionist, dieticians, and allied health-care workers.

Information Acquisition and Dissemination: This is going to be one of the primary objectives of the center when it becomes operational. It will gather, accumulate, and disseminate health-related information and materials to all anyone or agency who may need it irrespective of location or socio-economic background. Data and/or information collected will be coordinated, analyzed, and distributed throughout the country and the contact area. For health-care workers and professionals, symposia, workshops, and seminars will be organized by bringing in experts from various fields of health-care provision, distribution, and education to present state of the art lectures and practical information on techniques, protocols, and new trends in health-care. Not only are these symposia and seminars going to be held at the center some presentations will be organized throughout the target area to allow maximum exposure, coverage and attendance.

Public Health Policy Initiatives: As a non-profit health-related institution, we will, in co-operation with other health-care agencies initiate public health policies; make recommendations and make our services available on consultative basis for all who seek us out. We will analyze on-going health-care polices to determine their effectiveness and finally we will put our facilities at the disposal of health agencies to help implement health-care programs.

Protocol and Implementation

This project is based on the fact that prevention of common curable illness in the rural areas is better than the cure. It is also less expensive when providing basic information on good hygiene, nutritional practices and self-administered health-care practices to rural communities in the developing or less developed third world countries. To accomplish this objective subject matter experts will be assembled and consulted on the various topics; training of paramedical staff, prenatal and postnatal care, nutrition, hygiene, first aid, immunization and vaccination. Next, a series of audio and video presentation materials supplemented by pamphlets, for school children, will be prepared in local languages and dialects. Thirdly, health-care personnel will be trained to use and to present the materials to the local folks in their own language and dialect during village meetings. These presentations will cover areas such as hygiene, nutrition, immunization and vaccination, pre- and post-natal care for women of child-bearing age and mothers, and first aid practices. After the initial presentations to rural communities, the project will be evaluated to determine its effectiveness. Evaluations will be conducted through community-wide survey in the target or coverage area. One of the main targets of this project is the youth (children and young adults), therefore it is our hope that with local input and resources the presentations will be accepted favorably by the target audience. The overall goal of the project is to increase attendance in schools, reduce infant mortality and morbidity and thereby enhancing the socio-economic well-being of rural folks.

The project is divided into five (5) phases including but not limited to:

(i)development of health-related information materials;

(ii) training of local staff and personnel to carry on the activities of the project;

(iii)presentation of information, materials and services to target audiences;

(iv)evaluation of services; and

(v)distribution of acquired information to other areas.

During the first phase of the project a target community will be chosen in Ghana, West Africa based on the following factors; local language; and logistical consideration including transportation and community involvement. Next phase will bring in local subject matter experts in the area of first aid, hygiene, immunization and vaccination, nutrition and pre-and post-natal care. Information will be collected, edited and translated into the local language and dialect of the target community. In the third phase, an arrangement will be made with local chiefs and elders in the targeted community to organize village meetings. The meetings will be attended by health-care personnel who will make audio and video presentations. Project staff will also visit schools in the area to talk about good and good health practices. The evaluation phase consists of a house-to-house visit by trained staff and trained volunteers to conduct a survey to assess the effectiveness of the presentations and information presented and to measure whether the people have been practicing what they have heard. The final phase of the project will depend on the outcome of the evaluations and other adjustments to the presentation and information dissemination. The project can be exported to other communities in Ghana and neighboring countries for implementation.

Funding, Finance and Volunteers

This project will be funded principally through donations from individuals and corporate sponsors. Other sources of funds include solicitations through writing of grants to foundations and other granting agencies and non-governmental organizations (NGOs). Some funds will come from local people and chiefs in the form of labor and in kind services.

VOLUNTEERS NEEDED: Would You Like To Volunteer Your Services And Experience?

Experience and Expertise Needed:

Physicians (All Specialties, Retired or Active)

Nurses and Nurse-Midwives (All experiences, Retired or Active)

Dentists (All Specialties, Retired or Active)

Dental Hygienists

Pharmacists (All Specialties, Retired or Active)

Pharmacy technicians

Medical Technicians

Blood Banking

Clinical Laboratory Technicians

Microbiology

Duration: Two (2) or More Weeks

When: Flexible

Location: Rural Villages in Ghana, West Africa

Please Note That CRHP Provides Free Accommodation For Its Volunteers.

Are You Interested? Please Complete the Form Below or Contact:

Dr. Yaw A. Nsiah, Dr. Margaret S. Withrow

CHRP, Project Coordinator 232 E Street, NE

221 York Road Washington,DC 20002

Lebanon, CT06249 E-mail: fwithrow@aol.com

Tel: 1-860-465-4524

E-mail:nsiah@easternct.edu

Charitable Donations Accepted

Financial or Cash Donations

Materials (New, Refurbished Or Used) May Include the Following:

Medical Diagnostic Equipment

Microscopes

Preparative Centrifuges

Refrigerators/Freezers

Blood Banking Equipment

Microbiological Equipment

Dental Chairs and Associated/Related Equipment

Beds

Monitoring Devices

Others

To Make Donations or Inquire About Possible Donations, Please Contact Us At The Address Below:

Dr. Yaw A. Nsiah, Dr. Margaret S. Withrow

CHRP, Project Coordinator 232 E Street, NE

221 York Road Washington, DC20002

Lebanon, CT06249 E-mail: fwithrow@aol.com

Tel: 1-860-465-4524

E-mail:nsiah@easternct.edu

Research Programs and Projects

Maternal Mortality and Morbidity

Training of Traditional Birth Attendants

Prevention of Neonatal Tetanus

Governance and Staffing

Governance: The overall decision making body of the center is entrusted in the Board of Trustees/Advisors (BOT) who will be in charge of planning the short and long-term goals of the center. The composition the BOT will comprise individuals from all areas expertise with commitment to the aims and objectives of the center. The day-to-day running of the center will fall in the hands of the Executive Director and the Chief Medical Officer - Administrator with input from other center personnel.

Below is the summary of organizational chart.

I Board of Trustees/Advisors

II Executive Director

III Officer

IV Medical Personnel

V Support Staff

VI The Community

Board of Advisors

Ms. Ellen WithrowBien, Bloomsberg, PA,

USA

Mr. David A. Asante, CRHP,

Ghana

Mr. Benjamin Manuh, Swiss Re, USA

Ms. Antoinette Duah, AT&T, USA

KwameBediako, Esq, Advocate/Barrister, Vancouver, BC, Canada

Dr. KwameBuahene, Internist/Dermatologist, Vancouver, BC, Canada

Dr. Winsome W. Whittaker, Internist, USA

Dr. Karen Cockley, Research Scientist, Wyeth-Ayers,USA

Staffing: Professional staff will include those with expertise in Medical Sciences, Medicine, Nursing, Psychology, Education, Nutrition, Social Work and the Social Sciences. High School graduates will be hired and trained to help as technicians and associates. It is expected that local volunteers, permanent and temporary staff members will be sort to work at the center.

Important Links

HIV/AIDS In Africa http://www.aids.org.za/

HIV/AIDS In Ghana http://www.undp/rba/regional/hivprol/ www.worldbank.org/afr/aids

Maternal Health http://www.who.int/mental_health

Infant Mortality In Africa www.who.int/health_topic

Vaccination and Immunizationwww.vaccines.who.int

Malnutrition/Neonatal/Tuberculosis/MalariaTetanuswww.who.int/health_topic

Antiviral Agents/Anti-Infectiveswww.who.int/health_topic

HIV/AIDS/Neonatal HIV/AIDS http://www.cdcnpin.org/hiv

Sexually Transmitted Diseases http://www.who.int/health_topic

Global Health www.globalhealth.org

Health Partnerships

Ghanawww.ghanaweb.com

Institutions and Centers

Eastern Connecticut State Universitywww.easternct.edu

Yale University School of Epidemiology and Public Health www.yale.edu

Center for Interdisciplinary Research On AIDS (CIRA) www.yale.edu

University of Science and Technology, Faculty of Medical Sciences, Kumasi, Ghanawww.ghanaweb.com/education

Centers for Disease Control and Prevention,Atlanta, Georgia, USAwww.cdc.gov

Organizations

Peace Corps www.peacecorps.gov

Peace Corps Returnee Association www.rcpv.org

International Voluntary Service www.pourperfect.com www.ivsgbn.demon.co.uk

Non-Governmental Organizations (NGOs) www.unesco.org/ccivs

World Health Organization (WHO) www.who.int www.who.org

Volunteers www.vfp.org

Doctors Without Borders -Medecins Sans Frontieres (MSF) www.msf.org

Voluntary Workcamps Association of Ghana (VOLU) www.volu.org

OtumfuoOsei Tutu II Education Fund www.otumfuofund.org

Pan American Health Organization (PAHO) http://www.paho.org

UNICEF www.unicef.org

UNESCO www.unesco.org

Sponsors and Supporters

The Withrow Family, WashingtonDC

Mr. William Bien, MiltonSchool System, PA

Dr. Martin Kankam, Kansas City, Kansas

Nana OduroKwaku, Kumasi, Ghana

Project Location and Demographics

CRHP is headquartered in Asamang - Ashanti, which is within the KwabereSekyere District. It is expedient to give a comprehensive demographic report on the essential elements that favor the location of the project there. The KwabereSekyere District covers an area of approximately 58 square miles, and the project site is located 27 miles Northeast of Kumasi in Ashanti Region of Ghana. It is bordered in the north by the Sekyere (Mampong) District, south by Kumasi City Council, east by Sekyere East District and in the west by the Offinso District. The administrative capital is Agona, which is five miles from Asamang, the project site. The District is made up tour sub-tribal divisions. Agona, Sekyere, Kwabere and Afigya each with its own paramount Chief. The Ashantis constitute the predominant ethnic group, followed by Hausas, and other people of Northern Ghana extraction who live in communities called Zongos.

Population Size: Age Distribution and Density

A total of 174,853 people live in 403 towns, villages and settlements with greater concentration of these people in the southern part of the district.

Age distribution

Under 5 years- 15%

Under 16 years - 40%

Under 51 years - 45%

Population of Asamang (the project site) is about 20,000.

Approximately 9,000 are adults and the remaining are children between 0 -17 years.

ECONOMIC ACTIVITIES

1. Economic Activities

Economic activities in the target area are presented in order of prevalence:

a. Farming constitutes the major work for the bulk of people. When it comes to economic activities, cocoa farming (which is seasonal) places first followed by food crops, cola nuts farming, oil palm, poultry and fish farming. Farming provides the bulk of personal income for majority of people in this area and the country as a whole.
b. Petty (retailing) trading of food stuffs, clothes, and hardware, and manual construction labor.
c. Two banks at Agona and Jamasi.
d. Wood industry, that includes bush sawmills, and carpentry works.
e. Cottage(e.g. Kente cloth weaving, dyeing of Adinkra, pottery). Per capital income is approximately U.S. $200 p.a.

2. Existing Utility Services

a. Electricity supply:

Twenty-four (24)-hour supply of electricity with intermittent rolling blackouts for most major towns, e.g. Agona, Kona, Jamasi, Ntonso, Asamang (the project site), Mamponten, and Aboaso.
b. Water supply:
Most towns have periodic pipe-borne water through pipes. Drinking water is stored in special receptacle, e.g., cans, tanks, pots, etc. Rainwater is stored also for drinking and cooking purposes. Greater majority of the people use different kinds of collecting cans, clean or dirty, to draw water from wells, and streams. The current hand pump system used in some places has corrected this unacceptable way of water drawing. People are generally, however, indifferent at protecting sources of drinking water and as a result they have become sources of persistent infections and infestations.

3. Refuse and Sewage Systems:

a. Refuse and Waste Disposal

Refuse is usually kept in open baskets, old buckets, etc., and sent to dumping grounds on the outskirts of towns in the morning. These are occasionally burned, hut they undergo natural decomposition and the end-product could be very useful source of natural fertilizer. Children may play at these places and scavenge through the dumps to pick little valuables. This forms another most important focus of contracting microbial infections and parasitic infestation. Besides, it becomes a good medium in which flies proliferate and act is disease carriers.

b. Sewage.

Indoor plumbing is a luxury in most households and cannot afford it in these areas. In some towns other than the cities and large towns some form of a sewage system may be present for household water and bathing. The bulk of the sewage, however, is not properly handled or processed for disposal. It is therefore very common to find these systems acting as temporal reservoirs for mosquitoes, toads, bacteria, and viruses; during the raining season these are washed back into streams and wells from which drinking water is obtained. People have indifferent attitudes towards sewage disposal around their houses.

c. Human Excreta

Due to lack of indoor water closets or toilet facilities, the majority of people use open public latrines, uncovered pit latrines, and "free-range" disposal in the bush. It is not uncommon to find people queuing to use public toilets/latrines. The ratio may be estimated at 300-500 people to one public latrine of about eight closets. The state of the public toilet system is very unhygienic and forms a most important focus of contracting infection and infestation.

4. Housing

Most houses are made a swish (mixture of dirt and clay) that had been plastered, in a detached and semi-detached configuration. Children commonly sleep with parents and grandmothers. Ventilation is only fair and in the absence of mosquito-proof sleeping nets, doors and windows are usually closed.

5. Transportation and Communication Network

The main Kumasi/Mampong road passes through about one-third of the district. Telephone systems are present but often non-operational. Wireless messages could be sent through police stations.

6. Educational Institutions

i. Secondary schools

a. Agona S.D.A. Secondary School

b. AsamangKonaduYiadomSecondary School

c. JamasiAduGyamfiSecondary School

d. WiamoasiOkomfoAnokyeSecondary School

e. AdamgomasiSecondary School

f. AdumanSecondary School

ii. SpecialSchool

a. AshantiSchool for the Deaf at Jamasi

iii.Vocational School

a. Agona Social Welfare Vocational School

iv. First Cycle Institutions

a. Total number of primary schools - 130

b. Total number of middle schools - 98

c. Total number of preparatory schools - 7

d. Total number of junior secondary schools 13

e. Total number of Senior Secondary School 7

7. Existing Health Facilities

i. Level C: A facility with at least one medical officer (physician)

a. S.D.A. Hospital, Asamang, Ashanti