Berkley Center

My current study abroad situation is not like that of most other students. My "class" consists of conducting my own research in the field and analyzing the data I collect. I am living in a small town in the north of Ghana called Navrongo, which I thought was quite rural before I began my data collection. I am interviewing women about their experiences at health facilities during delivery and seeing how it affects where they choose to seek care during subsequent births. Each morning I wake up at 4:30am and meet my field workers, three Ghanaian girls who speak the local dialects, and we drive out to the smaller towns around Navrongo where we interview women who were randomly selected to be a part of the study. Going out into the field has been an absolute eye-opener for me in terms of health and education. So often in First World countries, we read that the solution is always putting more resources into these rural areas that so desperately need help. If I’ve learned anything during my fieldwork, it is that the problem is not just about availability in these areas, but that it’s equally important to address quality, accessibility, and sustainability.

In Ghana, an initiative called the Ghana Community-based Health Planning and Services Initiative (CHPS) was developed to help address the availability of health care in its more rural areas. CHPS compounds, which are like small primary care facilities, were built and staffed in villages where people were not able to easily get to larger clinics or hospitals. After visiting many of these small villages, biking through tall grass reaching over my head and challenging cows, pigs, and goats for space on the dirt paths, I’ve realized that even with these CHPS compounds around, actually getting to them is even more of an issue than most people, and organizations, recognize. Many people in these areas don’t own a bike or other mode of transportation. They have to walk to reach these health facilities, and if they’re lucky, it will be with shoes that have already been worn out from miles of walking. The roads are not easy to maneuver, even on a bike. If one then adds being sick, along with the heat, which easily reaches 100 degrees by about 10 a.m., the walk is something I would never want to do. Even though the compound is there, reaching it is an entirely different obstacle to be tackled. These places are often understaffed and have lines of 30 patients or more waiting to be seen by one person. In addition to all these other challenges, health workers are often not properly paid, which results in low-quality care. Additionally, there are times where patients must travel farther to other clinics because the health workers or the necessary medications are not present at the nearest CHPS compound. These compounds were a great idea, but the implementation has left much to be desired.

The situation is the same for students going to school. I have seen so many children walking down the street to school asking for rides as the car from the research center I’m interning at drives me to my study locations. Many students walk over an hour to school each morning, only to do the same when the day is finished. I’ve seen children who are no more than 6 or 7 years old making these walks on a daily basis. They’re walking to classrooms that have 50 students and frequently are without air conditioning. In addition, these students must have money for their school supplies, uniforms, and school tuition, which many won’t have on a consistent basis. Teachers are often also suffering from a lack of resources, causing a lower quality of education. A Peace Corps Volunteer I’ve met, who lives in one of these rural villages I’m referring to, had to teach an entire day without chalk, making her job just that much harder. So the all too familiar situation becomes, if a school is built in one of these small villages will the teachers be qualified to teach? Will they have enough resources to educate? Or will the students not even show up because they don’t want to walk two hours to school? The educational issues facing these rural areas, and third-world countries all over the world, isn’t just about making sure the school is there. It’s about making sure that what goes in the school after it has been built is sustainable and up to par with educational systems of other high-income countries.

Help from international organizations is so often based upon assumptions and eagle-eye views of various areas. In order for international aid to truly be effective, research on the ground must be done to assess what the real barriers are to health and education. Though it can never hurt to build a school or a health clinic in places where they don’t already exist, more thoughtfulness in terms of quality and sustainability of these aid tactics is crucial. There is so much more that meets the eye when it comes to solving the problems facing Third World countries and rural areas today, and it’s something that I think must be addressed if the global community truly plans to help build a better world.