Cerebral Malaria Inspires PCV to Take Action in Ghana

By Terrie Schweitzer

My counterpart, Stephen Sah Kwame, and his wife, Veronica, had been at the hospital for a couple of days. This time, when I stopped by, Stephen took me back to the ward to see their son, 15-year-old Kwasi. Every day they had told me, “Oh, he is better!”

I wasn’t prepared for what I saw. The boy made flapping motions with his arms; his legs ran endlessly as he lay on his side. His eyes were closed, his head thrown back. The skin of his face seemed pulled back tight over his teeth. He was in a different world, a different realm.

Eventually they moved Kwasi to the larger hospital in the nearest city. Stephen and Veronica traveled with him, providing the nursing care that families usually provide themselves in the Ghanaian medical system. The other children were sent to live with their grandparents. The oldest girl came every morning to sweep. The younger ones ran up to me if they saw me in town. Veronica grew thin. Stephen’s farms went unattended. For over six weeks, the family was thrown into complete disarray.

Kwasi had cerebral malaria. And this is how I came to realize what a profound affect malaria has on entire families, especially women and children. I realized that some of the deaths I had heard of recently, that were described as “she had a bad headache”, could have been due to malaria. I wanted to try to do something to help.

I am an Agriculture volunteer residing in a small cashew farming village near the border of Cote d’Ivoire. We have a co-operative which operates a cashew processing factory in town, providing women with employment so they don’t have to travel to larger cities. The factory has two sides: a side where they crack and shell the raw nuts, and a side where they peel and sort the kernels. There is a fun tradition at the plant: every year, they hold a women’s football match: the crackers versus the peelers. It’s a game just for fun, and to celebrate the women of the processing plant.

My idea was to tie this event to a malaria prevention event. I talked it over with my supervisor, Matthew Sah Kwadwo. He agreed that they would like to have such an event in the village. “I have an idea,” I told him. “Perhaps we could get a trophy for the women. The winning side will get to keep the trophy on their side of the plant for that year; then the next year, they can play again and the other side can try to win it back.” He agreed that this was a fine idea. The women would like it a lot. “Do you know where you can get a trophy?” I asked him. Oh yes, he told me…there was a place just in the next village. I was surprised; thought we’d have to go to Kumasi or Accra for that.

I wrote up a plan for the event and submitted a grant request to the GYD committee. We didn’t need a lot of funds; we asked for 140 cedi and were excited when we got it. The executive committee of the processing plant gave us another 100 cedi.

Starting top-left and rotating clockwise: Stephen Sah Kwame, PCV Danny Suits, local student, PCV Jasmine Staff,
Matthew Sah Kwadwo, Clement Obeng, PCV Terrie Schweitzer, PCV Chase Henderson, and David Pokau

We had another PCV group as a resource: the SWAT (Standing With Africa to Terminate) Malaria Team. I contacted our regional representative, Danny Suits, and he agreed to bring the SWAT Malaria Bucket and help us present a program. I also sought the help of other PCVs in the area; Chase Henderson and Jasmine Staff joined us, and brought health professionals from their own communities, David Pokau (Ghana Health Service official, arriving with Chase) and Clement Obeng (nurse arriving with Jasmine) to help act as translators and facilitators.

It seemed like a simple event, but in the days leading up to it, I was surprised by the number of details that had to be worked out. Stephen and Matthew did a great job of ensuring that the event was announced at every church and mosque. “Did you get the trophy?” I asked. Oh yes, Matthew told me, I have it. Matthew is also the cashew co-operatives plant manager; he helped make a big day of it by having the women do their annual “clean up day” at the plant, then expanded out into the community to sweep the streets. This drew attention to the event as the women explained what they were preparing for as they made their way through different parts of town. “I will bring the toffees,” Matthew told me. Toffees? Oh yes; he had gotten toffees he could hand out at the event. “Everyone will get one.” I was impressed that he was taking the initiative to add in yet another dimension to our day.

The team arrived shortly before noon and we ate banku (and three of my roosters that were supposed to have been hens) in my yard. Danny went over the activities in the malaria bucket. Then we made our way to the funeral grounds in town, the gathering spot for any program.

A large crowd had already started to gather. We’d hired a sound system which also helped attract attention. I was anxious about the event, but when Jasmine requested “Lapaz Toyota” and convinced one of the young women to dance with her, I knew that everything was going to be alright.

We greeted the chief and elders, and then did introductions. Danny started things off by beginning a demonstration of how to make neem cream, a natural, locally made mosquito repellent lotion made from boiling neem leaves down to neem tea and adding soap and coconut oil.

Our original plan was to have three stations that people could visit to do the malaria bucket activities. But we knew we had to be flexible, and when we looked at the large crowd surrounding us on three sides, many of them seated in chairs, we changed tactics. We sent a facilitator and translator to each side of the crowd, and they presented the activities to everyone within earshot. When finished, everyone rotated to a new section. It worked even better than I expected. It was really great to see people responding to the activities. They loved the sense of humor that Chase brought to the bed net demonstration, they loved Danny’s enthusiasm, and they just loved everything about Jasmine.

Counterpart utilizes the BCS Malaria Flip Chart while crowd looks on.

I also really enjoyed seeing Stephen, Matthew, and Clement take leadership roles in the event. I could see their confidence grow as the day went on. They made it easy for me.

There was one odd moment early in the program when Matthew brought a copy of our schedule over to me. “Where do we give out the toffees?” he asked me. Then he pointed to the very end of the schedule. “Oh, yes, here it is,” he said happily and walked away. He was pointing to the line that said, “End of game, awarding of trophy.” That’s when I suddenly realized that he thought “trophy” was “toffee”.

OK, so I could have done a better job of following up on that detail. We closed the program with the distribution (some might add “and riot”) of forty cedi worth of toffees. Thus we have what Chase calls “The Toffee Trophy Incident of 2012”.

Are you ready for some football?

The crackers and peelers arrived at the funeral grounds in uniforms they’d borrowed from area secondary schools. They even had one for Jasmine, a ringer for the peelers who are always the underdogs. The players jogged and cheered their way to the football field, followed by a Kia flatbed truck hauling the sound system and generator, still playing to the delight of an endless parade of dancing kids.

I always think of my village as a town with a lot of heart. People work hard but always have a smile and a greeting to share. Whatever they do, they do fully, whether it’s trying to comfort and restrain a flailing delirious son who’s trying to combat malaria in a hospital bed or play football, barefoot, in borrowed uniforms on an October afternoon.

Kwasi continues to make a slow and arduous recovery at home. I see him and Stephen in front of their house sometimes, Kwasi practicing walking with a staff and Stephen coaching him along. He’ll miss at least a semester of school. There was fear that he might lose some hearing, but luckily he seems to have recovered that ability. Gradually, things seem to be getting back to normal for the family.

We estimate that there were over four hundred people in attendance at our event. The question and answer session revealed that people had learned a great deal during the event and were taking an active interest in how they could prevent malaria for themselves and their families.

We are very grateful to GYD and SWAT Malaria Team for their support of our event.

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