Daniel Osei Bonsu is a 14-year-old boy resident of the Wawase in the Afigya Kwabre district of the Ashanti region in Ghana. Daniel, a junior high school student of the local Roman Catholic School registered with the Women’s Health to Wealth (WHW) Boys’ Club program in May 2018. The program trains adolescent boys to attain life skills required for self development and to contribute positively towards the development of their communities.
About a year ago, Daniel got so ill hat he sometimes missed a whole term of school could not participate in the National Juvenile Football Association of which he was a member. After seeking medical help from a local community clinic without any improvement, Daniel’s parents concluded that, the source of his illness was spiritual and started seeking help from local spiritualists.
Daniel’s absence in school and during club sessions was reported to WHW by the club facilitator. A team from WHW visited Daniel at home after he two weeks of absence from club sessions in June 2018 and found him in a critically ill and helpless situation. Despite the fact that his mother was convinced it was a spiritual issue, she was encouraged to send Daniel to the WHW hospital in Kumasi. Daniel was found to be severely anaemic and required urgent blood transfusion. He was referred to and admitted at the emergency unit the Komfo Anokye Teaching Hospital (KATH) where he was transfused with three pints of blood and later hooked onto a ventilator. Sadly, Daniel was unable to make it and passed on seventeen days after intensive care at KATH.
Daniel was diagnosed as having a congenital malignant blood disease that usually affect other siblings. This disorder occurs in people with a compromised immune system and in persons that have a family history of having this malignant disease. It was evident Daniel received late treatment for this disease because parents and his community attributed his sickness to work of demons in the spirit world.
With this knowledge of the cause of Daniel’s ailment and the fact that this disease is genetically transferrable, his parents were urged after being educated on the nature of the illness to send his four other siblings for testing. As the saying goes, “A stitch in time saves nine”– even though we lost Daniel, we have had the opportunity to save his four other siblings through early detection and appropriate treatment for two others who also have the same problem.
Fig. 1. Group discussion among boys during a Boys’ Club session.
Deborah Mensah Duah.
Between December 2015 and May 2016, WHW Girls Clubs members were given fruit trees to nurture as a way of learning how to be responsible and responsive to issues that affect their lives. Girls Club members were taught to consider and represent the fruit trees as their dreams and therefore were tasked to always reflect and adhere to principles of plant growth as fundamental precepts for realizing their dreams. Moreover, Girls Club members were given these fruit trees to grow as supplements for food and vitamin minerals.
Girls Club members in Aduamoa D/A JHS received eight fruit trees made up of four seedlings each mango and orange that were successfully planted in May 2017. The members were alarmed when five of the eight trees were vandalized by unknown assailants in July 2017 and therefore provided special fencing to guard the remaining three plants.
In April 2018, when Girls Club members (2018 Graduands) realized that the Ministry of Road and Urban Development (Ghana) was going to construct a road from Aduamoa to Aduman that would affect the parcel of land housing the fruit trees, they quickly sought assistance from the school authorities to transplant the fruit trees which had grown and firmly rooted in the soil
The students provided animal manure and building blocks as fence for transplanting. In May 2018, the students with their teacher-facilitator successfully transplanted the remaining three fruit trees which are about 25 months old. Unfortunately one fruit tree died as a result with the remaining two alive and growing steadily.
Girls Club members have learned from this experience that they need to be current, observant, proactive and cooperative in life especially on their education and health. They have also gained the experience of going extra mile to do the impossible by changing their environment and also by turning threats to opportunities in order to achieve their dreams. With the teacher-facilitators coordinating this activity, exited Girls Club members have left legacy of Girls Club members protecting one another from harm.
Written by Abraham Kwasi Nkrumah (Program Officer, WHW)
Keeping girls in school can sometimes be as simple as giving a girl a routine blood test, or as complex as rescuing a teenager from a violent home. In the impoverished urban settings where WomenStrong International works, we clearly see every day the direct link between health and education among the adolescent girls who are part of our Girls’ Clubs in Ghana, Haiti, India, and Kenya.
At Women’s Health to Wealth (WHW) in Kumasi, Ghana, a member of the WomenStrong Consortium, we run 34 Clubs in junior high schools where, in line with Ghana School Health Policy, School Health Education Program Coordinators liaise with the Ghana Health Service to educate adolescent girls on a variety of topics. Adolescent girls are taught about personal hygiene, dental health, nutrition, fitness, human sexuality, pregnancy prevention, and prevention of HIV and sexually transmitted infections (STIs). Girls also learn about the dangers of tobacco and drug use and about avoiding gender-based violence.
When WHW saw that neither Ghana’s Health Service nor Education Service were conducting health screenings, they began offering essential tests for visual, aural, and dental health, as well as testing for STIs and anemia. Hundreds of girls have been screened through the Clubs.
None of the girls had ever had a health screening before, and we received the full support of education and health staff at the district and local level, who understood the importance of basic health services for young girls but had been unable to offer them.
Testing revealed that more than half the girls between 14 and 16 years of age were moderately anemic.
The immediate impact of anemia is extreme fatigue and an inability to focus, both of which, obviously, impact a girl’s ability to study and learn. Longer term, if left untreated, anemia leads to difficult or dangerous pregnancies and low birthweight, sickly babies. Globally, anemia is the leading cause of maternal mortality. Most often, in poor settings, it is the result of not getting enough nutritious food to eat.
Not surprisingly, the screenings in Ghana found that one-third of the girls tested were malnourished, with a BMI of less than 18.5.
Girls receive the results of their screenings right away, and for those diagnosed as anemic, a 90-day course of treatment with iron-folate supplements is provided. After treatment, their blood is checked again. All girls in the Clubs are given folate supplements each school term.
In addition to treatment, we took on the root causes of anemia by offering nutrition education classes and the planting of kitchen gardens to help provide girls with one nutritious snack or meal each and every school day.
Girls needing additional care, such as the removal of a tooth or glasses, are given referral letters from WHW to school officials explaining what the girls need, so that the schools can work with parents to obtain medical care through doctors at district hospitals.
WHW’s own medical team working at the Girls’ Clubs includes a dentist and a dental assistant, an optometrist, an eye nurse and assistant, and two WHW staff members who conduct some tests and teach lessons in nutrition.
As a result of the health education and screenings done through WHW’s Girls’ Clubs, we have seen a 45% reduction in school absenteeism due to ill health. Teachers report that girls are more attentive and are eager participants in class activities. Fewer girls are reporting menstrual disorders, such as scanty blood flow and painful menses.
For high-school aged girls, WHW and WomenStrong offer adolescent reproductive health fora, held each year to address such topics as sexual reproduction, STIs, unsafe abortions, menstruation, mental health, and contraception.
About 85% of the forum participants are well into their late teens and are sexually active. As many as 18% have given birth to at least one child, in fact, while 37% have terminated at least one pregnancy. We have seen that reducing unwanted pregnancies means making more and better information available on contraception. The Adolescent Reproductive Fora are designed to fill this information gap, all within the context of the importance of staying in school.
Our meetings are held in safe spaces where girls hear from speakers from the health ministry, interspersed with skits and other tactics designed to create a relaxed environment where girls feel comfortable expressing their fears and asking their questions. Girls participating in the fora benefit from one-on-one counseling with adults who can answer their most pressing sexual health questions. In these individual sessions, counselors hear from frightened girls who are pregnant or carrying an STI, such as Candidiasis and Trichomoniasis. Treatment is provided on the spot.
The private sessions also have helped identify girls in abusive relationships. Over the last two years, WHW has rescued nearly a dozen girls from abuse, including girls facing violence at the hands of close relatives, and even one girl who was selling sex in a desperate effort to earn enough money to pay her high school fees.
WHW partners with Marie Stopes International, to provide sexually active girls with condoms or longer-term contraceptive options, as well as support if they find they are pregnant.
Not all those referred to Marie Stopes are in trouble; indeed, some are leaders. At the end of each year’s reproductive health forum, about 10 -15 girls volunteer to become trained Peer Educators. The Peer Educators are given hotlines to WHW’s Health Coordinator, as well as the Youth Coordinator at Marie Stopes, and are taught to give the phone numbers to any of their high school peers who may need help.
Above all, the collaboration between WomenStrong and WHW means that hundreds of girls are able to remove many of the health-related obstacles to finishing school, so that they have a real chance for a better life and a better, healthier future for their children.