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fhn Projects - Ghana and Ecuador

fhn Project in Ghana

fhn Ghana directs a sustainable development program, focused primarily on improving the health of those who live in Boamadumase and the surrounding villages. The dedicated personnel in Ghana divide their time between working in the Health Centre and the local communities with necessary administration issues.

	Project History fhn's involvement in Ghana began in 2003. However, unlike Ecuador where they started from nothing, fhn inherited the Ghana project. In 1989, Mrs Huttel, a German lady who lived in the same village as Martin (fhn co-founder), was on a charity visit to Ghana. In one of the villages, she encountered a midwife who was delivering babies in appalling conditions. She pleaded with Mrs Huttel to help. Mrs Huttel realised that she could make a real difference to the local communities. After much deliberation with village elders, the construction of a Health Centre was started in 1994. Mrs Huttel ran the Health Centre until 2002 when ill health made it impossible for her continue. Having heard about fhn's success in Ecuador, she approached Martin to ask if fhn could run her project. Dr Ed Gold and Dr Martin Eckhardt left for Ghana in 2003 to visit the Health Centre and gauge local commitment to the project. As in Ecuador, the communities were 'unrecognised' by the Ghanaian government, and had relied on Mrs Huttel for their health provision. Today, fhn co-ordinates health care and other relevant community projects for the people of Boamadumase and the surrounding villages.
		The Health Clinic Before fhn took over the Health Centre, health care was provided by a medical assistant working alone in a semi-built clinic with minimal equipment or medicine. Today, the Health Centre provides 24/7 medical attention with a full compliment of Ghanaian staff. Specialist volunteers (predominantly western doctors) have provided quality control and augmented the training of the Health Centre staff. The Health Centre services include medical consultations, complete midwifery services (antenatal, partum and post-partum care), full laboratory services, vaccinations and in-patient stays with all the key staff living on site. In addition, referrals to the local hospital of Agogo enables us to provide all-around high-quality health-care. Around 8000 people are now provided with medical assistance from fhn's Health Centre in Ghana. As with the sister project in Ecuador, we also provide community health services. The larger communities have elected one male or female health promoter to undergo training as Community Health Workers. This group attends weekly workshops on health-related topics, such as first aid, malaria testing and sexual and reproductive health. fhn's health promoters are also representatives of the Health Centre in their communities, spreading health education messages throughout the region. In an effort to make the Health Centre as self sustainable as possible and to ensure continued support from the communities, all staff members (wherever possible) are resourced locally. fhn's priority is to provide stable and effective health services at each project site, ensuring that these services are relevant to the needs of the local communities. We view health from a holistic perspective and therefore also run programs in the fields of education and environmental health. We ensure that every aspect of our work is culturally, socially and financially appropriate.
	The People Communities within Boamadumase and the surrounding area exist under challenging circumstances. The region is isolated and the village where the Health Centre is located is around 4 kilometres into 'the bush' from the nearest road. Once at Boamadumase, the region's other communities are connected via a series of trails, accessible only by foot. The people live in conditions of extreme poverty. The average annual income of a family (often up to 12 members) is £ 200 per year, the majority of which is used to buy food. The local government had already sunk two bore-holes in Boamadumase and fhn is working with the other communities on potable water, since surrounding villages have no fresh water supply. Only Boamadumase may be connected to the national grid, the other communities have no electricity. fhn Ghana concentrates its efforts in Boamadumase and the surrounding area. Here around 8000 people live in seven distinct communities. Boamadumase is the main community in the region due to its proximity to a road. This is where the Health Centre is located. There are a large number of both indigenous and non-indigenous tribes, with over ten dialects spoken. The majority are Ashante and speak Twi. Other immigrant populations have arrived recently from the North, for hope of arable land to farm. They are mostly Muslim and speak Fra-Fra or Hausa. Education within the region is extremely poor. Whilst some communities have a 'school' for primary education, resources and personnel are scarce and pupils are often needed in the field. Secondary education is almost non-existent, and economic realities often deter attendance. Women are of special concern. Whilst women are integral to the survival of the communities, inequality and violence make their lives particularly difficult. Women's health is integral to a community's development and antenatal, postnatal and midwifery services are key factors.
		The Region Boamadumase is situated in the Ashante region, which is located in the centre of Ghana. It is around one and half hours from Kumasi, Ghana's second biggest city. The area is reasonably flat with minimal change in altitude. The temperature fluctuates between 25 and 40 degrees celsius with two distinct seasons. Wet and hot, dry and hot. The region lies in the middle of the malaria belt. Malaria accounts for a significant number of the deaths in the area. It is also plagued with high rates of other infectious diseases. Before Mrs Huttel and subsequently fhn started work in the area, there were no health care services at all. Locals would have to walk up to seven miles to reach the nearest road, from where there could take local transport to a government clinic at Konongo. The distance, cost, and time needed, discouraged many from making the trip. There are two schools in the region which are both structurally poor and often closed due to lack of staff. Whilst there are two bore holes in the central village, this is over six miles away from some of the more remote communities.

	fhn Project in Ecuador
	fhn Ecuador directs a sustainable development program, focused primarily on improving the health of those who live in the region of El Páramo. fhn Ecuador works alongside the Ecuadorian Ministry of Health. The dedicated personnel in fhn Ecuador divide their time between working in the office in Quito and in the field. For extra information other than displayed below, please visit fhn's USA site here.

	Project History Conceived in 2000 and started in 2001, this was fhns first project. Dr Martin Eckhardt (fhn co-founder and President of fhn Germany) was planting trees in the Ecuadorian cloud-forest, which is a place of almost unrivalled biodiversity, forming part of the Mache-Chindul Reserve. Martin spent several months in the region and during this time was moved by the plight of over 20 communities in the jungle. They were 'unrecognised' by the Ecuadorian government, and therefore had NO provision of health or education resources. Martin offered a solution to the community leaders: if they would commit to building a health facility and provide the necessary local support, he would undertake to raise the funds and help manage the project. Martin returned to Europe and recruited several committed people to help raise the necessary funds and provide the required expertise. The group included Dr Ed Gold (fhn co-founder and President of fhn UK) and Karin Friederic (President of fhn USA). Martin returned a year later with $25,000 to build a Health Centre and fhn was formally founded in Quito a few months later. Today, fhn provides a large and varied range of community-based services focused on providing health care and education to the people of El Páramo.
		The Health Clinic El Subcentro de Salud officially opened its doors in the community of La Y de la Laguna on December 15th, 2001. In order to ensure continuity of medical personnel, fhn Ecuador and the local health committee (El Comité de Salud) signed a contract with the Ecuadorian Ministry of Health As a result, the Ecuadorian Ministry of Health provides a rural doctor and dentist to work in the Health Centre in La Y. In order to administer the Health Centre, fhn works closely with El Comité de Salud , which is composed of members from local communities, who represent local interests. The Comité de Salud is instrumental in coordinating all of fhn's activites in the region. It is intended that the Comité de Salud will eventually independently administer the Health Centre. To this end, the members of the committee undergo workshops to teach them the necessary management skills. Furthermore, as part of the effort to transfer management of the Health Centre to the communities, the centre currently has two members of staff resourced from the local communities. One has been trained to perform laboratory investigations and the other is a nurse. In August 2002, each of El Páramo's 26 communities elected one male and one female health promoter to undergo training as community health workers. This group attends one workshop per month (each lasting between one and three days) on health-related topics, such as first aid, malaria testing, sexual and reproductive health, basic ophthalmology, medicinal plants etc. fhn's health promoters are also representatives of the Health Centre in their communities, helping to spread health education messages throughout the region. fhn's priority is to provide stable and effective health services at each project site, ensuring that these services are relevant to the needs of the local communities. We view health from a holistic perspective and therefore also run programs in the fields of education, environmental health and gender equality. We ensure that every aspect of our work is culturally, socially and financially appropriate.
	The People Communities within the El Páramo region exist under challenging circumstances. The region is very difficult to reach from the 'outside'. The central community of La Y de la Laguna is 40 kilometres away from the nearest road, along a simple track into the jungle. During the summer months, this journey can take two hours. However, during the rainy season it can take many hours through thick mud or may be impassable. Once at La Y, the region's other communities are connected via a series of muddy trails, accessible only by mule, horse, or on foot. The people live in conditions of extreme poverty. The average annual income of a family (usually 5-10 members) is £ 300 per year, 80-90% of which is used to buy foodstuffs. fhn is working with the communities on potable water, waste management and hygiene. The inhabitants of El Páramo subsist off the land's natural resources, yet lack of information about ecology and conservation has resulted in deforestation and poor yields of crops. Furthermore, the natural characteristics of the region mean that the local communities face huge challenges to their health. Not only does El Páramo lie in the middle of the malaria belt, but it is also plagued with numerous other infectious diseases. Access to the clinic varies, with the nearest communities less than our hour away by foot and the furthest around 8 hours. In the wet season, walking becomes extremely difficult.. Education within the region is extremely poor. Whilst some of the larger communities have a 'school' for primary education, resources and teachers are scarce. Secondary education is almost non-existent and economic realities often deter attendance. Women in El Páramo are of special concern. Whilst women are clearly absolutely integral to the survival of the communities, pervasive gender inequality and a culture of 'machismo' serve to discourage females from participating in the community as fully as they would like.
		The Region The area that fhn Ecuador concentrates its efforts is called El Páramo where over 6000 people live in 26 distinct communities. These communities are made of different ethnic groups. From Colorado Indians to the more common mestizo. La Y, the main community in the region due to its central location, is the key commercial centre that now benefits from a Health Centre and community library built by fhn. The outlying communities are connected by muddy footpaths, accessible solely by horse, mule or on foot. El Páramo is partially situated within a national ecological reserve entitled Mache Chindul, which stretches over an area of 119,172 hectares. Mache Chindul is situated in the province of Esmeraldas in the North-West of Ecuador. Mache Chindul is made up of a variety of ecosystems, including zones of tropical humid forests and pre-mountainous humid forests. The region, which ranges in altitude from 200 to 800 meters, is situated between the coastal mountain chains of Mache and Chindul, from which the ecological reserve gets its name. These mountain chains are situated only 29 kilometres as the crow flies from the Pacific Ocean and they link the humid region of the north with the dry region in the south. The temperature fluctuates between 20ºC and 40ºC and the region receives between 2000mm and 3000mm of precipitation per year. The area has a high concentration of endemic species and as a result it is regarded both nationally and internationally as an area which needs to be protected. Biologists and international organisations alike recognise the ecological importance of the Mache Chindul reserve. Particular to the region is the Laguna de Cube which is protected by the international institution RAMSAR and thought to be the largest jungle laguna of its kind in Ecuador and possibly South America. In this same region, the private ecological reserve, 'Bilsa' managed by Fundación Jatun Sacha, helps protect the last 5 percent of the native tropical cloud forest which still exists in Ecuador. The region's ecological diversity and beauty mean that it is critical that local populations maintain their natural resources in a sustainable manner.