Mafi-Seva Community Clinic
Communities Come Together and Open Their Own Clinic
The Mafi Seva Community Clinic was set up with AMURT's assistance in 2003. There, Ghanaian health workers and birth attendants Emperor, Elizabeth, Bernice and Diana treat patients that come on foot from villages sometimes as far as 15km away. The clinic, like the water project, is community owned and managed and is now self-sufficient and open 24-hours, providing treatment to up to 200 patients monthly. The only other health facility is the poorly equipped hospital in Adidome 25 km away.
Diana and Elizabeth at the Seva clinic treat a man who cut his foot while farming
The Clinic Comes into Being
In early 2002, as the communities around Seva village realized their potential through their successful work on the AMURT Zongo Water Project (Mafi Zongo Water project), they decided to start a community health clinic and asked AMURT to assist them. Once the communities had prepared the building and sent candidates for training with Didi Vinambra at our AMURTEL clinic in Domeabra (see below), AMURT coordinator, Dada Daneshananda, helped with the organisation and start-up capital.
By the end of March 2003 the communities had a five-room building ready in Seva, and on May 1st the clinic opened. The response from the communities was impressive; an increasing number of patients started coming from surrounding villages and the following May the first baby was delivered in the maternity ward. Within the first month the Clinic was able to pay staff salaries, operating expenses and re-stocking of medicines. It was self-sufficient from the start, and by the end of 2003 had been able to save money in order to secure its own future. Now a second building, serving as staff quarters for the four permanent staff members, as well as volunteers, has been constructed on the compound.
Community midwifes being trained in delivery techniques – October 2006
The permanent staff includes Elizabeth, who came from the Domeabra Community Clinic, Bernice, a local trained health worker and Emperor the manager/health worker, who is also the main co-ordinator for the Mafi Zongo Water Project. The clinic also trains local community members like Diana, who was taken on as a trainee in May of 2006 and has the opportunity to become a permanent staff member.
Emperor (in sky blue) is the driving force behind AMURT’s Mafi-Seva Community Clinic and community health programs, as well as the coordinator of the Mafi-Zongo Water Project in Ghana which provides 9,000 people with clean water. His style of leadership is softly-spoken and is an inspiring contrast to the commanding style that is all too common in African villages.
He is able to diffuse conflicts and restore harmony where there is discord by being humble and truthful, and always straightforward. Emperor leads by example and gets things done. He is always first in line for any kind of physical work, enabling him to mobilize people in several dozen villages for communal labour.
What do they treat?
The common complaints are malaria, colds, diarrhea, and injuries. There is a strong focus on women's health, hygiene and sexual health education. The clinic staff also delivers, on average; four babies a month in the maternity ward and provides antenatal and post-natal consultations. Sometimes they make home visits and the clinic's Land Rover is used as an ambulance to transport patients for emergency treatment at the hospital.
“Cefas got a small cut while farming, left the wound untreated and nearly lost his foot in the infection that followed. Luckily our clinic ambulance took him to the only hospital equipped to help him, more than two hours away, and is today, miraculously, fully recovered. It is not unusual however, that people in the communities have to amputate body parts or even die from simple wounds that get badly infected. An emphasis of the Seva clinic is therefore education on basic wound care and hygiene.”
Local Health Out-Reach - Workshops and Training
Local out-reach in the form of day-clinics and health education programmes in the surrounding villages, is an important part of the Seva Clinic. Emperor and the rest of the staff believe that preventative health education is the key, and their aim is to train and inspire more local health workers to run these programmes.
Until now they have been mainly carried out by visiting volunteers with assistance and translation from Emperor and Bernice. However, a new programme, KEKELI, meaning 'brightness', has been launched to train Women's Village Health Promoters. The first group of 13 trainees graduated on 10th April 2007.
Midwifery training for local TBAs (Traditional Birth Attendants) as well as sexual health education programmes for teenage girls have been carried out by international volunteers, many of whom have been put in contact with the clinic through Kids Worldwide. Eight TBAs have been trained and equipped in this way.
The teenage girls in Mafi Seva village learn how to use a condom in a sexual health workshop conducted by clinic staff and volunteers in July 2006. Abortion is illegal in Ghana and many young girls go through dangerous abortions by, for example, taking chemicals or putting sticks in their vagina for a couple of days. Increased knowledge and availability of condoms would mean that fewer girls would put their lives at risk in this way, as well as protecting them against sexually transmitted diseases; an increasingly common complaint in the communities around Seva.
Other volunteers have given workshops on nutrition and the danger of incorrect use of drugs, which is a big problem in the area, as antibiotics can be easily bought from street vendors in the towns and used without correct prescription.
A few cooperative games and lots of laughter turned out to be an excellent remedy to get rid of shyness and any other boundaries before starting the workshop on sexual health by volunteers Moksadevi and Sumati from the UK.
Education could also prevent the widespread problem of needless infection of minor wounds and scratches, which in the worst of cases has led to permanent physical disabilities or amputations.
Community Participation - the Key for Success
In AMURT we put great weight on trying to initiate projects, which involve and are independently run by members of the community. The key behind Seva Clinic’s success is community participation. It is managed by a committee of representatives from Seva and nearby villages, with open communication and transparency in the finances. The communities themselves use the clinic and feel that it belongs to them. In this way we believe that the clinic can serve as a model for other clinics to be opened by AMURT in Ghana and other countries.
In May 2004 a second clinic opened in Adalekpoe village, also in the Volta Region, which is now operating well, although not yet entirely self-sufficiently. The nearby Workpoe community has also built facilities for their own health post. AMURT is ready to assist and is awaiting further initiative from the village members.
The clinic is still quite simple and is always in need of expanding its supplies and acquiring new equipment. The solar power installed in 2005 provides energy for lights, which means it can stay open 24 hours a day, but the irregular power supply stops them from storing vaccines and medications that need refrigeration. A more regular power supply could, in the future, also allow for a small lab for blood testing. These are just some areas in which the clinic could use more financial support.
Another aspiration of the clinic is to strengthen its outreach programs and train local health promoters in every village. Volunteers and clinic workers would work in partnership to spread the necessary knowledge to local communities. This would lessen dependency on AMURT's presence in the future.
Domeabra & Akwakwaa Community Clinic
Didi A.Vinambra from Zambia, the project officer for two community clinics in Domeabra and Akwakwaa, Ghana, is a certified trainer with the Ministry of Health, and trains community members in practical nursing. Her trainees are integrated into the Ministry’s immunization programmes in the area.
Didi A.Vinambra is a life volunteer, dedicating her life to serving others. She is also a certified trainer with the Ministry of Health
AMURTEL, sister organisation to AMURT, started its work in Ga Rural, in the Greater Accra Region of Ghana, in 1984, with these two clinics providing basic clinical care to the villagers as well as health education and basic training in midwifery and first aid.
Domeabra Community Clinic
The Clinic in Domeabra gets on average 8-12 patients a day, which doubles on market days. The staff, consisting of Didi, Gilbert and the TBA (Traditional Birth Attendant) Akele along with Didi’s students, also conduct between 5-10 antenatal consultations a day and usually assist 8-12 deliveries per month. The majority of the patients are women and children, and common complaints include malaria, colds, diarrhea, and injuries.
Many mothers come to the clinic regularly to get their babies checked
At the Domeabra Clinic we focus on preventative health and the staff are all members of the local community. They are involved in making sure that there are safe and hygienic drinking sources in the villages and talk with pregnant mothers about bringing up young children as well as giving advise on birth control measures. The clinic is planning to develop more of these kinds of interactions with the surrounding communities through puppet plays and theatre and we hope that the ideas and inputs of more volunteers will stimulate this to become a reality.
The clinic building at Domiabra is simple yet spacious. Here women come from several nearby communities to get assistance in safely delivering their babies.
At the moment Didi has 6 students, Richards, Mary, Ojasina, George, Abigail and Christiana, who live and train at the Clinic and are given a monthly allowance. Didi often co-ordinates trainings with AMURTs other clinics, so that all staff and trainees can benefit from each other, as well as, the knowledge and expertise of volunteers coming from abroad. Just last summer (2006) Mary and Richards, trainees at Domeabra, went to Seva Clinic (above) for a four week training course with nurse Mila from Canada. In the past some of Didi’s trainees have stayed to work with her and one of her first graduates, Elizabeth, subsequently went to work with AMURT in our Mafi Seva Community Clinic in the Volta Region.
Didi A.Vinambra and the Traditional Birth Attendants (TBAs) that underwent training in October 2006 with Sunitii, a professional volunteer midwife from England
Didi’s next plan is to build a proper hospital in the village. Recently construction was started on a fence around the plot, which is the first step towards securing the land that was given by the community for this purpose.
Akwakwaa Community Clinic
The health outpost in Akwakwaa, Central Region, was first opened by AMURTEL in 1999, and the permanent clinic was established and opened in 2002. Some of Didi Vinambra’s trainees were sent out to staff this post as part of their practical training. Not only were they successful in their work, but they also caught the attention of local chiefs, who invited them to provide health care assistance in their own villages. As a result we opened another clinic at the beginning of the year 2003 in Nyanoa.
At first the Akwakwaa Clinic was run in rented premises, but soon after opening the clinic, and seeing the interest and needs of the community, AMURTEL purchased 5 acres of land with a beautiful river and coconut trees on which to build a proper clinic facility. The clinic building was completed in 2005 and now staff quarters are under construction.
The clinic at Akwakwaa
The staff and their work
Apart from our watchman Mam Ali, the Akwakwaa Clinic is staffed by Isaac, Wisdom, Sarah, and our TBA Ante. They treat an average of 9-14 patients daily, and conduct 112-115 antenatal and 3-5 deliveries a month. Some TBAs, wise old women from the communities, have also joined our trainees in the two clinics, where our facilities ensure that deliveries are made safely and that any complications are dealt with early and effectively.
The staff at Akwakwaa. From Left : our watchman Mam Ali, project coordinator Didi A.Vinambra from Zambia, Sarah, our TBA Ante, Bernice, Isaac, Wisdom