Law of Averages

Submitted by Ben Sholes

So, roughly a month ago now we started encouraging the Fulani men to consider using a budget system.  It quickly had an initial impact of showing them how much they were actually spending on the items they decided to track.  However, the cool thing about budgeting is that it gets more effective over time (if you have the discipline and the right techniques).

As of the last Fulani session, we finally had enough spending data to start taking a look at trending analysis.  Across two spending categories, we were able to take weekly totals over a month and derive an average of what they "should" be spending on those categories (from a purely historical perspective).  Today, we got to see the results of using those "average" numbers, and they were surprising.  Not only had the men used their numbers to try to limit their spending, there were cases where they were purposely changing their habits to "beat" their average number. A good example of this is one of the men consolidated his normal twice a week trip to get food to a once a week trip thus cutting his food transport costs by half.. He said it required moving money around from other purchases, but he understood that ultimately he would be spending less money overall. Can you say, "I think he gets thepoint"?

It will take a lot more time, discipline, and experience to perfect juggling finances for these guys.  But, I'd say they're on the right track.  Great job, fellas.

A penny saved is a penny earned...

Submitted by Ben Sholes

Three weeks ago, we distributed a rough budget template sheet to the Fulani men in an effort to help them understand how they were spending their money. Despite the sheet only have two categories (transport and phone credit), the results were pretty clear: they learned that they didn't realize how much money was going toward those two items. Goal number one accomplished!!

Riding that wave of realization, we continued to talk about what that fact means. We discussed about how to look at trends in their week to week spending, how much the total cost of each item compares to their total revenue, and if the items that they are tracking are actually money makers for them. After sufficiently blowing their minds, the universal question that was asked was, "Are we spending too much money on these items?" And, like a smart group, they answered their own question: more categories needed to be tracked! Goal number two accomplished!!

Next week we'll continue with more about money management as well as get into wound management.

Health education ... it'll take a village.

Submitted by Michaela Sholes

Ben and I had the opportunity to observe a local community pull in their fishing nets from the sea. About mid-morning, we noticed individuals start pulling on the lines that led into the sea, but didn't think much of it as they were rather far off. Over the course of the morning, we found that there were in fact two groups (one on either side of us) and as they continued pulling the lines in, were getting closer and closer to where we were sitting. By the time they had pulled in the lines to within a quarter of a mile from the shore, it was almost noon. They would take short breaks, but continued to work together at what obviously hard work.

It wasn't until this point that we began to fully understand and appreciate what we were witnessing. People seemed to come from everywhere to help. The young, the old, everyone in between...those who couldn't physically pull helped by directing where to put the ropes and nets after they were out of the water. As more people appeared to help, we noticed that they were singing a song to help them keep rhythm, thus keeping from stepping on each others toes (no easy feat when there are more than 50 people on each rope!) . We were fascinated by the way the entire community comes together to achieve this task, everyone pitching in for a common goal that they will all benefit from.

How much then, will they be able to achieve when they are pitching in for the benefit of everyone's health? If only it were that simple...

Community involvment is critical

Submitted by Michaela Sholes

Things are never as simple as you might think... One of our goals within our efforts is to continually support the existing health infrastructure, and one of the ways we are doing this is by collaborating with as many local resources as possible. Since helping the young lady we mentioned some time ago, Ben and I have developed a good relationship with nurses at a local hospital. When the nurses became aware of our efforts on the lake, they helped us arrange a meeting with the head doctor to discuss potential collaboration. We had hoped to meet with him last week, but it was right around the Easter holiday and ended up needing to be moved to this week, but we managed to liase with the nurses about a good time to catch him in between rounds! Upon finally sitting down with him amidst all the people around clamoring for his attention, we shared with him our work on the airfield and in the communities and introduced the idea of including in our health packets posters from the hospital. Ideally, we would like to support the work of GHS by including their posters so that the messages and graphics are familiar to those in the communities. Although the doctor was very kind, we learned that before he can authorize the provision of any materials, we have another meeting to attend at the district level. So from here, Ben and I will try to schedule the necessary additional meetings and continue working for local support of the communities. Until then, I for one, really like the posters the AvTech girls made!

Working to resume classes in the Fulani school

Submitted my Michaela Sholes


Audrey and I had a lovely time at the Fulani camp this morning, where we met with the community for a much more informal session than we've had as of late. Many sessions recently have targeted a specific group in order to gather their feedback as we determined the best way to move forward with the education classes, but today was open to anyone and we had a great group show up!

We began the session with our announcement to them that we would be resuming classes in the community the first week of May, so it will coincide nicely with the start of the new term with public school as well. By that point, my sister Rachelle will also have arrived and will be focused on getting the sessions started again as she spends the next four months with us! The community got a big kick out of the fact that she and I have both lived here as long as we have and our Twi is still "kakra kakra" (small small). It gave me an added incentive for me to improve my language skills!

Following our announcement about the classes starting again, Audrey and I did a short health education session on washing hands. I gave them a brief talk about the role proper hand washing can play in preventing disease in the camp and pulled from my days as a Preschool teacher with a song many of my former students are familiar. Sung to the tune of "Frere Jaques", we modeled washing the top and bottom of the hands as well as in between the fingers. Francis Norman, who had joined us for our session, played his violin with our song as we called on various people, both young and old, to model the song for the group. It was great fun for all and we shared lots of laughter!

The group also enjoyed a short talk and hands-on demonstration from Francis regarding his violin and the different sounds it makes. He took many volunteers to touch the violin and to try to play the instrument and it was cheering to see their faces light up as they realized they were helping to make that lovely noi...I mean, sound! Francis and his friend from Germany also brought with them some balloons which made for lots of cheer, despite one or two unfortunate little balloons that got too close to the spiky grass!

We will continue to be in touch with the community as we determine what days of the week work best for the different sessions, as we will now be holding the women's group separate from the children's group, in addition to starting the men's group with Ben.

Our new Office

Submitted by Michaela Sholes

Regular followers of the blog may have noticed last week, that when James from Battorkope came for a visit, our office was looking a bit bare. Granted, the walls, screens, and doors were up, there was some seating available, and we were thrilled to finally have our own space...but there was still much to be done! However, following the completion of two snappy new desks (lovingly crafted by our own Mr. Solo), Ben and I have taken the opportunity to officially move ourselves in! As you can see, we are still organizing and are in the process of having a bookshelf and some hanging shelves created. Today, Mr. Solo supervised the planning of the next step in getting the office and mini clinic ready.....sidewalks! We are so thrilled to kick off the beginning of the ETCHE program in such a lovely office, made by such talented people, in order to welcome such dedicated visitors as the volunteer health representatives!

At long last !!! WATER !!!!

Submitted by Ben Sholes

So, after 6 years, some hard work digging ditches & laying pipe, a little sweet talking to the water company (thanks, Michaela and Ben), and a whole lot of follow up with said water company, Kpong Airfield now has access to the main water supply. And, it is such a relief!

Prior to this day, all water for drinking, washing, and construction has been transported on-site via Polytank or sachet. You can read more about the dark ages here (Bens Blog). Without a doubt, this advent will save us major time, money, and effort. My favorite part is how it all works:

Instead of being able to use three different water sources that can be split up and sent to different parts of the compound, we now had to figure out how to split up one source of water for drinking, washing, construction, and cooking which take place in very different parts of airfield. The answer was very simple: tank + pipe. At the heart of the system, is a 3,000 liter tank on a water tower that is directly connected to the main water supply. This bad mamma jamma keeps us in water for roughly 3 days depending on "consistency" from the water company and our usage on a day-to-day basis.

From this point, we're basically set up with underground pipe to 3 different places around the airfield: accommodation, visitor washroom, and the office kitchen. These direct connections (once completely finished) will provide water to spigots outside the house for laundry, sinks inside the house for dish and hand washing, and the most important thing...showers! We've also hooked up what we call stand pipes at strategic places around the airfield where we may need water for washing planes & cars, refilling construction water tanks, and extinguishing bush fires.

Mark this day as one step closer to sustainability and standardization for the airfield and for MoM. With this new supply line, we will be able accelerate construction on the mini-clinic, more easily provide adequate water to big groups to host training sessions, and ultimately help MoM staff better utilize their time. Today is a good day.

The need for health education becomes apparent on our Dawakpersebi trip

Submitted by Michaela Sholes

The MoM team shared an encouraging experience having been invited to visit Dawakpersebi, one of the future recipients of the ETCHE bag-drop program! Noah, our local contact, introduced us to the community and their leaders and helped us facilitate group discussions to identify relevant health challenges and needs. During the discussion, we had an impromptu health education lesson after learning that Schistosomiasis and its related symptoms are highly prevalent in the community.

There were a number of health challenges discussed during our group meeting, ranging from typical issues (like asthma, allergies, and helminth infections) to more severe challenges like the situation experienced by this little girl. She was left scarred around her eyes following an infection in her face. Although she has been to the local clinic to address the infection which has somewhat subsided, she is still experiencing pain. We hope to collaborate with health professionals to help provide the best information possible regarding recommendations for clinic follow-up and prevention as much as possible.

Our host Moses and his family opened their home to us and were an absolute delight! Moses is the community youth leader and has been working with them for the last 5 years. He was very active in the group discussions and we appreciated his perspectives. His wife, Ayeki, is an amazing cook and made the most delicious palava sauce and boiled yam for dinner!

Rex, Melissa, Ben and I thoroughly enjoyed our visit (despite the crazy roads to get there!) and I cannot express how much I am looking forward to continued work with this community and others like them. This on-the-ground, community-led collaboration is what MoM is all about and we are thrilled to play an active role!

Let the Drops begin!!

We are all very excited about our first full fledged health education drop run. After 18 years of working to get the approvals and change regulations we’ll finally be taking healthcare to rural villages.

The ground Team: Michaela, Ben, Rex and Melissa have gone to a rural community to monitor the in-community reactions to the first set of drops. They will arrive there later this afternoon and spend a night in the village ready to share and document the first drop tomorrow morning.

Meanwhile the volunteer pilot, Patricia Mawuli and her student and co pilot Lydia Wetsi, are preparing the aircraft, bags, and materials for the drop.

Tomorrows run will be to 20 rural villages earlier identified by the queen mothers as target communities. The first contact materials being prepared include an introduction, a small questionnaire and some telephone credit for the community health rep to call us.

We’re often asked why we wish to use small aircraft for these runs. The ground team, traveling by road, will spend around 3 hours getting to first drop site. By comparison total flight time for this initial run to all 20 communities will take just over one hour in our Rotax powered CH701. Attempting this trip would require more than a week difficult travel by road, and would still not reach all 20 communities.

These first drops are more about first contact and relationship building. Future drops will contain more community specific health education materials and training invitations.

Fly ME Day!

Today is Fly Me Day.... we have invited over 150people this year, but with a difference.... we have focused on Queen Mothers and the children from their community. Twenty Queen Mothers have each been invited to come with five of their community children. In addition we have invited twenty from Techiman and ten from another school nearby, and of course Battorkope and a another nearby village who are the first beneficiaries of the airborne outreach activities.

Sadly, some have not understood the value of what we do. Some have asked for money to come to the event, and T Shirts and caps... We simply do not respond to such an approach. If the community cannot make the efforts themselves, they cannot benefit. The cost of getting to us from the communities in question is less than they spend on a new dress - and we believe that they need to demonstrate a 'desire for self-priority adjustment' as a primary change in attitude towards greater health.

What they do not know is that we will be giving out prizes and gifts to the children and a small financial gift for development of their community.

THis years line up of Pilots is Melissa Pemberton (9G ZAE), Patrick Ata (9G ZAC), Patricia Mawuli Nyekdzi (9G ZKT) and Capt. Yaw (9G ZAF)...
Lydia, Juliet and Emmanuella are on 'loadmaster duties' - that is putting passengers in and out of the planes!

Jenny Jocksh has flown in for the weekend to help and is running the passenger control - her title is 'Flight Line Queen' (control of the access to and from the flight line and photo taking with a polaroid (thanks to the Pembertons) of each child who flies...

Michaela Hayes is on 'first Aid Post and Queen Mother interaction, community liason' - probably the most important role for outcomes down the line.

Ben Sholes is 'Ring Master' and gets to try to herd the cats - getting cars in the right place and people control (includes all the headaches - poor Ben!!!)
Two staff have volunteered for security roles (Lele and Bernard)
Many students and friends will be helping too, special thanks to Paul H (safety car and fix it man), Soumya and family (marshalling and passenger pre- post-interaction), Aunty Judy (flight line support and gift support).

Special thanks go to Millward Brown for their financial support this year. We are, once again, running the event at a loss and thank WAASPS for covering over 60% of the event. 
We see the importance of this event and look forward to sharing the outcomes with you tomorrow!

(NOTE: We do not announce the date of this event in advance, except to invited guests, since we can get overwhelmed with 'opportunists'. If we exceed 300 people on the airfield we need to shut down operations under the regulations, and it is simply a way of working, but it makes it hard to gain support for the event. )

A Bungalow for two

Submitted By Michaela Sholes

Ben and I spent our first night in our new bungalow last night! There is
still some work to be done inside as Mr. Solo and his team finish the ceilings, some cement work on the drains, and some final touches, but all in all, it's coming together! As you can see, we are notorious for dumping our shoes at the door...so anytime any of you would like to visit, you know where to put your shoes!

Our next challenge once our bungalow is complete, is the mini-clinic, as evidenced by the post last week! As a follow-up to that post, she has regained much of her strength in the last week or so and has become a formidable Uno player!

Meeting with the Queen Mothers

Submitted by Michaela Sholes

Yesterday marked the first work day that Ben and I faced on the airfield while Pat and Jonathan are in Europe and I have to say…I’m pretty pleased with us at the moment =) I realize this well-oiled machine is the product of much TLC and the infrastructure put in place by those two…but it’s hard not to pat yourself on the back a little bit when you reach the end of what felt like a really long, busy, crazy but productive day and realize “Wow…I didn’t fall on my tush as hard as I was scared I might! I could do this again tomorrow…and maybe even the next day”

The highlight of the day was the visit to Manye Esther’s office to both pick her brain about some of our proposed health education topics and to introduce the concept of Fly Me Day to 20 or so local Queen Mothers. She had some great insights, not only on some of the topics that we should include, but also the presentation methods (i.e. a combination of posters, small flyers, booklets, balloons, etc). We had already identified health topics (i.e. water and sanitation), but she was particularly helpful in breaking the categories down and providing culturally relevant advice about specific areas (i.e. parents should be active role models and involve the children in the community in maintaining trash awareness and proper disposal)..

Although we had talked with Manye Esther about inviting the Queen Mothers and some of the children in their communities, this was the first opportunity I’ve had to address them directly. I’m not going to lie, my knees were knockin’ a bit under my kaba and slit (remember, traditional skirt/top outfit) as I’m seated in front of all these rather regal looking women. It’s a humbling experience but also an exciting one when one realizes that you are actually addressing royalty in the local sense. These women hold great respect in their communities and the effects of their support are irreplaceable.

They were very kind, both in their willingness to allow me to speak with them during an official meeting and in their patience with me as I bumbled my way through greetings in both Krobo and Twi. All meetings with the group are rather formal affairs in the sense that there is protocol to be observed and maintained, such as who to address when speaking (don’t address an aide instead of one of the Queen Mothers) and not to cross your legs while sitting with them (you cross your ankles, as it is considered highly rude and disrespectful to do otherwise). I was officially introduced to the group by Manye Esther before speaking to introduce myself and my purpose again. One of the Queen Mothers (Manye Makutsu: pronounced “Mah-KOO-choo”) was kind enough to translate for me as I introduced the concept of Fly Me Day and the purpose behind it. They were thrilled to be invited and promptly began planning group t-shirts and head scarves for the occasion (Here in Ghana, many events, regardless of whether it is a festival or funeral, are celebrated by ordering specialized T-shirts to commemorate the event. As I understand it, it’s almost about a sense of solidarity, of coming together as a group…and you show you are a part of it with a T-shirt or other specialized item such as a cap or scarf.) By the time I left, Ghana time true to form, what was supposed to be an hour’s meeting had become almost 4 times that. It makes me smile and I enjoy the fact that no day is ever alike.

We have a few challenges ahead of us as some of the communities are rather far, particularly those that we are hoping to target for project ETCHE, but we will put our thinking caps on!

Ho do you affectively interview someone?

The girls learned about research interviewing techniques today and did very well during their practice interviews. We had a great discussion about ethics in research and all of them did a great job of being “pleasantly professional.” I love having group discussions with them and seeing the way they think about things! They all did very well with balancing eye contact and not staring each other down while waiting for their “participant” to answer. After demonstrating an interview for them, I gave the girls an opportunity to practice by interviewing each other using sample questions from a youth risk and behavior survey I worked on a few years back. Tomorrow, we will talk about reliability and how that is important when considering interviewing participants in another language and translation issues!

The Keys to the Kingdom

Today is a big day for Ben and Michaela, after barely 4 weeks on the ground they are being given the keys to Kpong Airfield for one week. Although building work has come to a sudden standstill due to lack of cash flow, the upside is that they will not need to deal with masons for the week.... the downside is that B3 (their accommodation) has not yet got the drains sorted out and Mr Solo is still working on their bed and doors... remember we make it all here...

 We will use the available skills sets in the WAASPS staff to get as much done as we can, and Ben and Michaela will be starting some more training with the AvTech girls in relation to health care delivery, nutrition and other topics that will become an integral part of their involvements in MoM...

Perhaps the most exciting part of the day was the preparation of two bags for a quick bag-drop to Battorkope tomorrow, the only community we are currently allowed to drop to, with the documents that they need for us to fly some of their great young people at a forthcoming fly me day... (which will be a day with a difference - since we will also be flying up to 20 Queen Mothers on that day!)

We wish Ben and Michaela lots of challenges with opportunities and solutions during their 'first week of solo ops'!

Progress in the Fulani camp

Today saw an encouraging development in our efforts to renew the activities within the Fulani camp! Audrey, Ben and I arrived at the camp at 9:30am today in order to facilitate the planned focus group with the men, only to find the education building filled with…children. After a momentary panicked “Did they misunderstand and think we were starting up meetings again today,” their bright smiles and cheerful “Hello Madam” let us know they were apparently just glad to see us! Then I felt like a jerk. Alai arrived and explained that the men were just down the road and would be here soon. True to his word, within about 10 minutes, all 11 of the attending fellows had arrived and the meeting began.

In true Ghanaian fashion, what was intended to be an hour and a half meeting was finally called to close around noon with the suggestion that we all part for now, think about the information from the day, and schedule another meeting for mid-March to follow up. Although it was certainly more time than I anticipated, I was actually very encouraged by our meeting and the discussions that took place. I was also excited to see that almost half of those who attended were younger fellows in their early-mid twenties, who are typically not interested in these types of community activities Not only did they attend, but they also played an involved role in the discussions. Alhaji Jibril, a well-respected leader within the community, was also in attendance and lent support to our meeting.

The major points we took away from today’s meeting were the reaffirmation of their support in our activities, interest in attending some of our activities, and addressing the challenges associated with helping the school-aged children attend the local public school. We learned that not only do the men support the health and education activities that have been done with the women and children, but that they would also like to be involved. Until this point, they have been fairly adamant about their lack of time for such things. But during the conversation, they posed the thought that they might benefit from some of the health education and financial management skills, and by the end had suggested that if we could take an hour or so one morning a week, they would like to attend.

The majority of the time this morning was spent addressing the challenges they face with their children’s attendance at school. The current situation is that there are about 8-12 children who would like to go to school, but the taxi driver charges 120GH¢ per month to bring them to and from school. Some attendees expressed concern about being able to afford this expense (which is a valid concern) and thus we encouraged them to explore alternate possibilities. Once we established that MoM’s role in the community was not to build them a full-time school nor pay the taxi fees, as some suggested, most seemed open to suggesting options of their own. By the end of the meeting, there seemed to be some progress made and although no commitments have been made yet, it was a good environment to discuss options.

We have been asked to return in mid-March in order to follow up with them, which we will gladly do. After all that we have learned today and the insight from those who attended, I am excited to see what solutions they will find. It will be interesting to attend the women’s group next week to gather their perspectives on the matter and see how they are different or similar.

Following the men’s meeting, Ben enjoyed participating in the kids’ game of Keep-Away, while Audrey and I caught up with Amina to discuss next week’s meeting.

Ben and Michaela

Ben and Michaela are settling in, and making a big difference to our overall operations. Whether it is helping out with the admin, taking phone calls. running for water, moving cement, helping pull wires, writing letters, listening to the girls read, clearing drains, fighting fires, washing planes, getting covered in tractor hydraulic oil or giving us a fresh laugh when we are 'out'!

The brought with them plenty of gadgets, but still enjoy sipping on a bag of cool water (yes we have a working cooling system now!).

We all appreciate the new team members on the field and cannot thank them enough for making the sacrifices that they have to help us to change lives one flight at a time...

The Yapei Queen

Submitted by Michaela Sholes

 

Who loves taking a cruise? MoMMers, that’s who! Especially when it’s the kind of eye-opening and moving experience as Ben and I had this last week aboard the VLTC’s ferry, the Yapei Queen! Readers saw pictures last week of the ferry as we prepared for our trip, but in true Ghana fashion, there is always more to the adventure! Some highlights from our trip include: our cozy cabin and friendly fellow passengers who were kind enough to share their insights and experiences with us during our interviews, the small communities whose commerce often depends on the ferry and access it provides to outside resources, the beaches in said communities which were often covered in the shells of potentially bilharzia-carrying snails, and last but not least, breathtaking Harmattan sunsets.

We so appreciate the VLTC for providing us with a cabin for the duration of our trip! The staff aboard the ferry was very kind and we are indebted to them and others for helping us navigate our way around the facilities aboard! See our cabin and some friendly faces who have become very dear to us during this experience!

One of the most interesting aspects of our trip was the opportunity to sit down with passengers at various points during the trip and learn a bit more about who they are and their perspectives regarding health issues, access, challenges and all sorts of things. I will be sharing the results from our baseline interviews in the next blog or two, but just to give you an idea of some of the things we learned… Of the 21 individuals kind enough to speak with us, only 2 (less than 10%) were aware that there was a disease called Bilharzia and what its symptoms are. Another 40% knew that there was a disease from the water that could cause blood in the stool/urine, but NO ONE was exactly sure how to treat it nor avoid it. Bear in mind, that those who travel are typically more informed than your average individual living in an isolated community.

As a result of this trip, I find that I am even more driven to find ways to get this information to these communities who need it most. As you can see, the lake is such an integral part to these communities through providing transportation, water (for drinking, cooking, and bathing), food and many other necessities. We have an immense job ahead of us. It won’t be easy, but it must be done…and with your help, it can be done…

They are counting on us, and we together will change their lives, through Encouragement Training for Community Health Empowerment…

The sunsets were amazing. Feel frre to use this as your computers background. Let it remind you that we are in Ghana, making adifference in the lives of countless villagers every day.

We’re so happy Ben and Michaela are here we sent them on a Valentine Cruse

OK not really.......


Ben and Michaela set sail last night (Monday) for the North.  Hand carrying five Scholarship letters for the Kete Krachi girls for their entry to the AvTech Academy and the first steps on their way to becoming future MoM pilot/engineers... We made the ferry with seconds to spare, Michaela waving from the deck as they were casting off and sailing out from Akosombo Port.  On this trip they will be assessing the potential for health education to the 'captive' audience of the ferry on its four to six knot journey that will run day and night until they get back on Friday...  Internet access will be limited, but we hope that they will post something from their trip - if not wait for an amazing account upon their return!