The Coastal Groves Clinic Story

Trip Start Apr 01, 2007
Trip End May 10, 2007

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Thursday, April 19, 2007

It's something new everyday here - you just wake up and wonder what isn't going to be working today.  All yesterday the power was out and the generator wasn't working so we had no power, no A/C and trouble finding places with cold water because there was no power.  This morning the water is barely dribbling out of the faucet, so I guess the water is out.  Luckily there is just enough to get a shower - so I could wash off the bug spray from last night J  We laugh about it all the time, but I think we can so easily because we know we'll eventually be leaving Ghana and the power, water and internet will work at home.
             For the better part of the last week we've been working with our group on developing the clinic.  I know I haven't filled in a lot of the details about the clinic, because before I got here I really didn't know them.  So here's the story:
This all has to do with an orange juice factory outside of Cape Coast.  Daniel and his wife Mary are Ghanaians who lived in California for about 17 years in the 80's and 90's.  They had two children there and Daniel had been involved with a couple businesses, mostly involving computers.  They wanted to raise their children in Ghana and also come back to Ghana themselves.  So about 10 years ago they came back and bought an orange farm.  One of the men that Daniel had worked with in the US, Jerry, partnered with him.  The eventually got a co-op of a couple thousand rural farms together and started buying oranges and processing the orange peels (apparently there is a market in Europe for flavorings and teas).  In the first year they made about 80% profit from the peels, so they turned around and gave most of it back to the farmers telling them they hadn't paid them enough for the oranges.  The next season he paid them more and still made about 50% profit, so he gave them back money again.  He says that they've been able to substantially raise the value of the oranges so the farmers are making more money from their crops.  Over the past year they have been trying to switch over to processing the orange juice for export also.  He now has 3000 farmers, 2/3 of which are organic.  They cover a 50km radius north of Cape Coast in what is called the Central Region. 
Daniel says that he wants to raise the standard of living of the farmers and make them more self sufficient and self-sustaining.  Most live in 1-2 room buildings made of mud with thatched roofs, with families of up to 12 people.  There is no running water, but a water well with pump in each community, and very few have electricity.  It's really a different way of living than any of us can really imagine.  I asked Daniel why he wanted to come back and start a business here.  He said that he could do more here for people than he could do in the US.  Ghanaians are extremely proud but Daniel is one of the most humble I think I've met.
After a number of years of working with these farmers, Daniel has spent a lot of his own time and money on helping them with medical care.  The farms are very rural, many only reachable by dirt roads, which in the rainy season can become impassable at times.  The farmers work hard and don't have a lot of money, so they often put off medical care for as long as possible until they are extremely sick.  They don't really trust the regional hospitals nor have the money to pay for treatment, so when they have reached the point where they can no longer work, they go to Daniel to ask for help.  Malaria is the biggest health issue here (if you live here you can't afford to take prophylaxis like we do).  Daniel says that when symptoms first develop of malaria, if you treat it right away it costs a couple dollars.  But most of the farmers and their families put off treatment hoping to get better and only seek care when whey are so ill they need to hospitalized - so this delay is causing the cost to be 50-100 times more.
Daniel and Jerry wanted to start a medical clinic that would be located around the juicing factory and serve all the people in the area - not just the farmers and their families.  So that people stay healthier and are better able to work and take care of their families and themselves.
Since we arrived we've been learning about the communities, the farms and factory, meeting with people and trying to assess the health infrastructure of the country and current health needs of this community.  Ghana has recently started a national health insurance plan where you pay 60,000 cedis/year (about $6US) and supposedly everything is covered at the regional and district hospitals.  People have been slow to sign up and depending on who you talk to it works with different levels of success.  The Health Minister says everything is paid for, but when you talk to the people initially things were paid for but now they are not being covered.  For communities were people make less than $3US a day on average, health care is not much of an option.  We've heard some really heartbreaking stories of people whose lives would be changed by a $30 procedure that they can't afford.  It's incredibly sad.
But it's been a really productive trip.  Everyone is really excited about this opportunity and the clinic.  There's obviously a lot that we can accomplish here.  Tomorrow we have a meeting with the local chief who will grant us permission to have the clinic and will give us the land to use to build it.  It'll be my first meeting with a chief so I'm pretty excited!  We have a couple more people to meet with early next week.  Part of the group will leave on Saturday - they were doing some cataract surgeries at a local ophthalmology clinic.  Some others will leave on Monday and the following Wednesday, just depending on their schedules.  Then we'll have a couple weeks to tie up loose ends and do a bit more traveling. 
It's hard to believe that my trip is way over now.  I'm sure I'll be ready to go home by the middle of May, but right now I'm really happy that I have 3 more weeks left!
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