A CAT Psychotherapist in Upper West Ghana

Philippa Gardner, 2013. A CAT Psychotherapist in Upper West Ghana. Reformulation, Summer, p.41,42,43.

In February 2012 my daughter Sarah left the UK for a VSO year in Lawra in Upper West Ghana – a remote part of the country, hard to get to and very close to the border of Burkina Faso. Her role was to be an Education Support Ofï¬ cer tasked with improving teaching standards in 80 primary schools. All very admirable and character building, if rather concerning for her parents.

Lots of adventures quickly followed including scorpions in the kitchen, candles melting when it gets to 42 centigrade (no aircon) which was most days, living on your own in a house seemingly in the middle of a large piece of arid scrub land as well as travelling large distances by motor bike in remote areas.

Although Sarah took all the precautions against malaria that she could, most people in Lawra who are there for any signiï¬ cant period of time get malaria – the only variation is the outcome. If you get the right treatment quickly then you are just very sick for a week or so. If you don’t get treatment then you may not survive. We were reassured that Sarah made it to hospital, but less reassured when we found that the hospital had no running water and other basics that we associate with reasonable health care. She survived that challenge and many others too. By November tests showed that Sarah had had all 4 types of malaria. To cut a potentially long story short, we met up with Sarah in Majorca in August and learnt various things including:

Many of the people local to Sarah are very poor and uneducated. In certain seasons food is very scarce and she continuously had small children walking long distances to knock on her door and ask for food
She was encouraged by other volunteers to hold her boundaries – not let children into the house etc. She seriously reviewed this approach after resisting putting a child on her motorbike and taking them to hospital. That child died of a treatable infection.
Primary education is free and compulsory in Ghana but attendance in local primary schools is extremely low at 23%. If you are a 5 to 10 year old who has to walk several miles to school, and you haven’t eaten that day (and possibly not the day before either) and you will get nothing to eat at school then you’re unlikely to go
HIV is a massive problem. In the Lawra district the diagnosed HIV Positive percentage is higher than the literacy rate. Estimates of the undiagnosed HIV Positive rate vary from 20% to 50%.
Our planned “holiday” in Lawra in December might be a bit different from our usual holiday trips!

The outcome of the Majorca trip is that we agreed to set up a charity focussed on making a difference in the immediate area where Sarah lived. Action Through Enterprise was born and ATE is now a registered charity in the UK and incorporated as an NGO in Ghana - www.ateghana.org

School meals in Karbo Primary School. A cooked meal for all 400 children on the register every school day. This started in early January and is working well – attendance rates of children registered at the school have increased from 60% to 98%.
Small business sponsorship and supervision focusing on the HIV Positive community. It appears that part of the HIV cycle is that you get sick, can’t work, get diagnosed and are forced to sell all your assets to buy the necessary drugs. You then get better but have no equipment left and no way of earning a living. We run workshops to help build business plans and knowledge, and then provide grants and business supervision. My husband Charles’s career in management consultancy has gained a new wing: Mornings spent working with global food companies on their long term strategy followed by afternoons providing remote supervision to illiterate, poor, HIV positive, non English speakers who are looking to set up market stalls selling goods such as tomatoes, small dried ï¬sh and ground nuts. There is also one group manufacturing shea butter and a couple of groups who weave traditional cloth. We are now supervising 16 small business start-ups with most of them appearing to stand a good chance of being sustainable.
Special Needs Awareness Workshops (SNAP). This region is really not the place to be physically or mentally disabled. Sarah and 3 other VSO/Peace Corps volunteers have together set up a regular workshop aimed at providing support and some education to special needs parents and children. We attended the January meeting and we saw for ourselves how valuable these workshops are. At the one in February, at which 75 parents and children attended, many had walked several miles with fully grown disabled children on their backs to get there.

The January “holiday” arrived. Lots of stories to tell but we survived. The return journey south to Accra was particularly interesting - three hour tro-tro ride (decrepit mini bus, over- packed with people, literally falling apart!), followed by a sixteen hour night bus. The sliding door next to me on the tro fell off 4 times. Apparently that is quite normal!

At times we felt like a rather grubby dusty versions of the royal family – travelling by motor bike in the dry season on dirt roads does that to you. We were fairly visible as we were the only white people for miles around. We were guests of honour at the ï¬rst day of feeding at Karbo. Goodness knows what the 200 strong group of parents made of our speeches – they wooped a lot. I do know that my digestive system found eating the honorary ï¬rst meal too much of a challenge!

We are keen to evaluate the impact of what we do. Sarah has recently started a distance learning MSc in Poverty Reduction and has collected data about the children’s height and weight with a view to writing her dissertation on some aspect of the feeding programme. The details are yet to be formalised but she has already ascertained that at the start of feeding the children at Karbo Primary School 75% of the kindergarten children are dangerously underweight for their height and weight for this age group. We also know that within a week attendance rates at the school had rocketed. No surprises here!

We met with all the small businesses and spent a lot of time with the people and volunteers in the local area who will represent ATE in between the planned twice a year ï¬eld visits.

We attended the SNAP Workshop and delivered 100 pairs of second hand children’s shoes and clothes donated by Ramsbury Primary School. Matching these to the right children was elevating and saddening. Enormous excitement balanced by the sad reality that due to severe malnourishment, clothes for pre-school Wiltshire children ï¬t 10 year old Lawra children.

We came home for a happy reunion with our toilets and drains! We are also deeply committed to continue to support the courageous, impoverished people we met. We have created a charity in which all the money goes directly to the people of Lawra. We need funds to continue and extend the work we have begun. To help with this please visit the website www.ateghana.org

philippa@gardner4.plus.com

I am currently employed as a Consultant CAT Psychotherapist for Berkshire Healthcare NHS Foundation Trust. As part of this role I am the course director and principal trainer for the Berkshire CAT Practitioner Training.

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Philippa Gardner, 2013. A CAT Psychotherapist in Upper West Ghana. Reformulation, Summer, p.41,42,43.

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