The Agogo Hospital

We drove about an hour and half outside Kumasi today to the rural town of Agogo. The last kilometer brought us up over the top of a ring of small mountains that embrace this beautiful, tropical town. The hand-painted sign that welcomed us read “Akwaaba! Agogo-The Naturally Walled Town.”  No doubt that these natural walls have protected Agogo during centuries of power struggles between regional tribes and foreign invaders. Today, though the mountains still provide a beautiful frame for the town, they cannot protect the villagers of Agogo from tropical diseases and other modern threats to their survival.

The small streets of Agogo are bustling with energy.  The roads are shared equally by private cars, crowded tro-tros (the mini van taxis of Ghana), trucks hauling massive tree trunks and spewing black smoke, children playing, goats, chickens and dogs darting in and out, street sellers with their entire inventory balanced on their heads, businessmen holding cell phones to their ears and mothers carrying their children on their backs.  Bird songs weave together with blaring car horns, gentle children’s voices, raucous laughter, a crying baby, and the pounding rhythm of Hip Life music coming from homemade PA systems.

At the center of town is the Agogo Presbyterian Hospital.  This hospital/nursing school handles everything from emergency services, eye care and HIV cases to surgical procedures, and the treatment of tropical diseases. They not only care for large numbers of patients but also conduct research on new medicines and treatments. It is unbelievably inspiring to see what they accomplish at Agogo with so few resources.

We visited with two researchers that are testing a new malaria vaccine.  They hope that this disease, that kills so many children in West Africa, can not only be controlled but also eradicated.  It is common for malaria to account for 50% or more of the daily emergency room cases in Ghanaian hospitals. An effective vaccine would be no small accomplishment. We listened to the scientists describe the meticulous work of building the necessary trust in rural communities for medical trials, data collection, etc.  As they spoke, I was quietly struck with the fact that the research for short-term malaria prevention (for westerners) is far more advanced than the research leading to its elimination for children in places like Ghana.  The medicine I take daily provides solid (if not complete) protection during my month long stay in Ghana.  That medicine was developed in my part of the world for people like me.  The kids here suffering from malaria have not had the same attention from the medical marketplace.

The children found in one ward have a rare tropical skin disease called buruli ulcer.  This disease is found in many tropical areas of the world.  While little is known about how to prevent it, it seems to be related to the same bacteria that causes tuberculosis. Both the disease and the skin graft surgery (necessary for advanced cases) is disfiguring and debilitating. The antibiotic treatment requires a hospital stay of 3 months to 3 years depending on the severity of the individual case. Even after treatment, the disease often returns.

Agogo, like many Ghanaian hospitals, doesn’t have a food service. A family member must leave home, live at the hospital and cook for the child.  Since many of these farm families live on the edge of subsistence, losing the help of a child in addition to a mother, aunt, or grandma to a long-term stay in the hospital can tip the fragile balance of survival. All too often, parents of these children must decide whether to feed one child in the hospital or the others at home-an unbearable choice, but one that cannot be avoided. Many of these kids get abandoned at the hospital. The hospital does the best it can.  Sometimes families share their food.  Sometimes there are no other options. On top of all this, malnutrition impedes the child’s ability to respond to treatment.

There is a one-room school in the middle of the hospital.  The room is about 12 feet square with a blackboard, some benches and some simple wall paintings of rainbows, dolphins and the ABC’s.  There are no books, notebooks or pencils. There is no teacher. One volunteer from the next town comes in occasionally to read to the kids in the ward. Mothers and grandmothers that come to cook read to the children if they are able. They need learning materials. They need people. The long-term stay at the hospital without regular schooling sets these kids behind their peers back home.  Upon their return, many of these kids drop out of school. Combined with the disfigurement of this disease, these children face a long and terrible list of challenges.

After today’s visit, some of our SUNY Geneseo students set up a mini fund within our group to buy a bunch of food for these kids. Toward the end of our stay, I will have the Santa Claus job of delivering a couple big bags of rice and a barrel of palm oil.  This is one of those places with very clear, definable needs that yield immediate results.  The rice we deliver will provide some necessary help in the near term.  But Agogo needs an institutional partner to ensure that these kids get good food and a solid education.  Just as the rolling mountains embrace this town, the embrace of a grandmother, a teacher, a college student, and an institution is necessary to protect these beautiful kids.

More on Agogo later… the kids’ faces are still in my mind…its hard to get them out…I don’t think I want to.

I had better sleep.