UPDATE: Ensuring Insurance

I have finally been able to sit down and reflect upon my experience with the health insurance campaign—being jetlagged has never served me so well. Before I begin, let me preface this post by declaring “Ensuring Insurance” a success. With everyone’s help, we were able to provide health insurance for 494 children! This means that 494 children who previously did not receive prompt, high-quality medical treatment due to financial reasons will now be able to do so.

Throughout the campaign, I encountered obstacles that were at times overwhelmingly disheartening, but ultimately proved to be a tremendous (and much needed) learning experience.

As many of you know, my initial goal was to raise $600 to provide health insurance to the 300 uninsured children in the rural village of Hodzo Ga. While, thanks to generous, compassionate supporters, I was able to more than double my initial goal (so far we have raised $1,780!), I originally believed that raising funds would be the most difficult aspect of the project. I thought that registering children would be simple; the paperwork was extremely straightforward, I had the support of prominent community members and then there was the incentive of free health insurance for a year—a promise that I thought was sure to entice people to attend the gathering.

An example of the formed used for health insurance registration

Let’s just say I was wrong. Fundraising was the easiest part. The hours I spent trying to find the best social fundraising website, writing a campaign blurb that accurately described the project without being excessively wordy (I may have failed on the wordiness aspect…), fighting with the finicky internet connection and convincing my friends, family and complete strangers that my cause was worth supporting were extraordinarily straightforward compared to the rest.

With fundraising, I was in control. My actions and my work were reflected in how many people donated, liked the facebook page and spread the word. With registering children for insurance, I was not. Going into the project, I was oblivious as to just how many other factors influenced the registration process: communication barriers, cultural divides, a lack of infrastructure, and the ever lingering question: is this even the right thing to do?

I had begun the health insurance campaign because I was overwhelmed with the helplessness that I constantly grappled with while volunteering at the hospital. Witnessing people dying and knowing that I could do absolutely nothing motivated me to find some manner, no matter how small, to change the situation. But after the first day of registering children for insurance at Hodzo Ga, I was engulfed with helplessness yet again. However, this time it was worse; I had tried my hardest to do something positive and I had not succeeded.

Looking back, what I considered to be failure—not registering 300 children in Hodzo Ga for health insurance in one day—was actually a success. 157 previously uninsured children in Hodzo Ga now have health insurance! The frustration I experienced at the small number of people who showed up, the chaos of the registration process, and the attitude of some health insurance officials towards the impoverished community members taught me a valuable lesson about public health work: everything is a lot more complicated and requires a lot more work than it may seem.

I learned from the obstacles of the registration process at Hodzo Ga how to plan a more organized registration event for the next day. As difficult as it was to accept, I realized that I needed as much help with the project as possible. This was not a situation where I could work hard independently and immediately see results. Turning to George, one of the nurses who works with Blue-Med, for help was the best thing I did.

He spoke to a friend of his, Gloria, who is a nurse in Dodome, another rural community. Gloria immediately spoke to the community and organized a gathering for the next day. Together we discussed the situation with the insurance officials and figured out a way to make the event run more smoothly. The registration at Dodome was a huge success. We were able to sign up 337 children for health insurance in one day!

Registering everyone for insurance in Hodzo Ga

The health insurance officials, Freya and Amelia (two of the other Blue Med volunteers) and me. So excited after ensuring so many kids in Dodome!

Throughout the entire process, I have learned so much, both about myself and about doing public health work in a developing country. Having now left Ghana for my final year at UC Berkeley where I am studying Public Health and Global Poverty and Practice, I am continuing to reflect on the benefits of “Ensuring Insurance”. In the short term, it is wonderful—almost 500 children will experience immediate improvements to their health care. In the long term, however, will it create a cycle of dependence? Will families not value providing health insurance for their children, thinking that a foreigner will come and register them for free? These are questions with which I constantly grapple.

I am working with George and Richard, the director of Blue Med, to expand “Ensuring Insurance” in a sustainable manner that breaks the cycle of dependence. As our discussions and ideas begin to manifest themselves, I will resume fundraising.

A birth!

7/19/12

I am still in shock—today I saw a birth! It was absolutely incredible and has taken me several hours to process. Four hours later and I’m still having trouble believing it. 

Sara and I walked into the maternity ward asking if there were any imminent deliveries, excepting to get the usual answers of “You just missed one” or “not for several hours”. However this time, we were rewarded with a casual “Yes there’s one right now”. And off we went to the delivery room, not really expecting to see anything.

I walked in and was greeted with grunts coming from a woman lying on a hospital cot. She was making so little noise that I was sure her contractions had just started and it would be hours before the baby was delivered.

Not even two minutes later, the baby’s head began to appear! And with a monumental push, the rest of the baby popped out. I just stood there in complete shock, my mouth hanging wide open, trying to process the scene in front of me. I had just witnessed the miracle of life!

The baby was incredibly tiny, but breathing and crying and very much alive. It was such an amazing experience! Although I am definitely scared of childbirth now…

Getting Cultured

7/8/12

This morning I went to church with Abi and Alex, two of the British volunteers. It was an incredibly interesting experience. The room was packed with rows of portable folding metal chairs. Everyone was wearing very beautiful colorful dresses and shirts, definitely seemed like their Sunday best. We got there a bit after the service had started because we went to a different church first where the service was just ending. By the time we arrived at Assemblies of God, the minister had brought 5 people from the audience to the front of the room and had them kneeling. It seemed like he was going through each of them one by one and discussing their lives and their sins. I’m not positive though. Although the service was in English and then translated into Ewe, it took me awhile to adjust to the minister’s accent.

After he finished with the five audience members, he preached about the benefits of marriage. He repeated this sermon three times throughout the service, really trying to drive his point home. He kept saying how people in relationships need to validate their union through marriage in the eyes of God and that marriage was not just for young people. He called upon an older couple in the audience who had either recently gotten married or were going to get married soon as an example of older people doing the right thing in God’s eyes. He continued by saying that those who were living together but did not get married would no longer be members of the church.

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The Assemblies of God church, while everyone is still inside

 

The music during the service was absolutely amazing. They only played two songs but both were so beautiful. One was sung by the choir and the other by what seemed to a be a band. The band played this song called “Try to be more like Jesus”, which, although the lyrics were a bit off putting for me, was really inspirational because of the singer’s passion. The band consisted of one lead male singer, several male and female back up singers, a drummer and a guitarist. It was pretty cool. They all had amazing voices.

A man from the audience then gave a long talk about the importance of higher education for Ghanaian youth, which was really fascinating as well. The speech itself was a little tedious and hard to understand but the fact that the minister called upon this 20 something year old man to come up and talk about the benefits of a college education and how important it was for parents to foster their children’s desire to go to school was very interesting and forward thinking.

The minister himself was an intimidating figure. About 6.5 feet tall, very muscular and wearing a fancy suit, he had a very commanding presence. He really knew how to work the crowd, both with his voice and with his gestures. Most of the time, he was yelling at the audience, repeating his most important phrases for emphasis. Throughout his sermon, he used a race metaphor to illustrate people’s life course and goal of entering heaven. It was a very powerful image that he pounded home with slow motion running down the aisle, a loud voice and a variety of examples. At one point, he began preaching about how they should not associate with non-believers because they “will cause the believers to not be admitted to heaven”. He was storming down the aisle as he described how non-believers would taint believers in the eyes of God, and I was legitimately scared for a second that he knew I was not religious and throw me out of the church… Obviously that did not happen, but it was startling to see how many people raised their hands or stood up in agreement with what he was saying.

Throughout the service, people who were very inspired by the minister’s words would show their devotion by either standing or raising their arms or both. The service was much more interactive than the ones I have experienced in the US. Members would not only stand or clap at various occasions, but the minister would also call on audience members to add to the service. At one point, he called out a sleeping women and spent a few minutes discussing the rudeness  and consequences of falling asleep in church.

After sitting their for an hour and a half, we left, although the service had yet to finish. We think that it was wrapping up soon after, but I’m not sure. Overall, it was a really interesting experience and I’m glad I went but I’m not sure if I would want to go to a Ghanian church again. I wish I had been able to take pictures but I didn’t want to whip out my phone in the middle of the service.

Getting Situated

7/5/12

I just got back from the municipal hospital. Today was short since it was our first day and we’re still getting adjusted to the time difference, the heat, the food… pretty much just being in a developing country on the other side of the world.

Alicia and I spent our time today in the pediatrics ward at the municipal hospital. (There are two hospitals in Ho, the municipal hospital and the regional hospital.) It was surprising at first to see such a stark difference between the hospital here and our hospitals back home. A large portion of the hospital is outdoors, covered merely by an awning. The wards, which are all indoors, held just the bare minimum needed for medical procedures. It was heartbreaking to see the kids just lying there in these beds that look like cages.

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The supply room at the pediatrics ward

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An example of the beds in the pediatrics ward

There was a baby with malnutrition (just born 3 weeks ago) that was so so tiny, I thought it was going to whither away. He was legitimately all skin and bones. At first, he couldnt even cry, but in the few hours we were there, with the help of some calorie rich baby formula and love from his mother, he started getting visibly better.

There weren’t many mothers or kids there that spoke English, but I chatted with one for awhile that did. She was 20 years old and was there with her second kid, a girl that had had malaria but was doing much better now. It was crazy to hear about her life and compare how different our worlds are. I can’t even imagine having 2 kids (one with malaria), no husband, no health insurance and no money to pay the hospital bill. And despite all this, she was happy and full of life.

It’s hard to bond with the patients when we can’t communicate, since many of them don’t speak English. I’ve been practicing a few phrases in the local language, Ewe, and can now say “hi”, “how are you”, “I’m fine”, “what’s your name?”, “how old are you?” and “where does it hurt?”. I’m trying to remember these and to learn more, but I keep butchering the pronunciation!

Coming back to our hostel after the hospital, I’m once again struck by how nice it is. The buildings seem to be only a few years old, and very clean. There is a communal kitchen, common room with wifi (!) and amazing, tiled, large SHOWERS! Alicia and I even have our own room. The area surrounding the hostel is so lush and green. It’s surreal.

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The Blue-Med hostel

There are 15 other volunteers here right now: 14 British college students and 1 American high school student. The Brits leave in about a week and then they’ll just be four of us.