After having been to BCS in 2011 on the grade 9 Team Ghana trip, I had taken note of a few things. Though what stood out to me the most was the vast range of English spoken and read at BCS. While some students were fluent, others could barely understand what I was saying to them or could only catch a word or two. In fact, sometimes, these children were in the same class. Second graders barely knew phonics and in the fourth grade class, some students could read entire books aloud while others struggled to read a sentence. For my Mission 10 project, I decided to find some sort of a solution to this problem. In order to do so, I met with Mrs. Costanza, a ZIS mom, who works with the UBS Optimus Foundation. Together, we were able to track down literacy tests developed by Ghana Education Services. To assess the level of English spoken and read at BCS, to track the progress of students as they grew older, and to track the effectiveness of the teaching of English at BCS, I decided to use these tests. The test is composed of three sections:
- Listening, Reciting, and Conversation – Passages are read to the student and are then asked questions about the content
- Grammar and Vocabulary – Students are asked to identify and describe what is going on in a picture, identify proper sentence construction as well as the correct use of tenses
- Reading – Students are asked to identify words and letters as well as to read words, sentences, and passages
That June, I went to BCS with the Ghana CWW trip. For me, the focus of the trip was split between painting buildings, teaching and administering the literacy tests. I tested students from grades 2, 3, 4, and 5 and the next year when I went independently, I tested the same students to track their progress as well as to try and identify patterns in each grade and inform teachers about what they needed to focus on. Looking back from the initial results, it is evident that students tested showed progress and overall, all students were doing better than had their peers in the year before.
After reflecting on my trip in 10th grade, a major issue I noticed when at BCS in 10th grade was the growing amount of health issues present. BCS students were plagued with eye infections, bloated stomachs filled with worms, and infected scrapes and cuts all over their bodies. There was lots of work to do and solving those problems would just be the beginning of much work that needed to be done.
At present, over 600 million school age children are at risk of being infected with parasitic worms. These worm infections are found throughout sub-Saharan Africa where there is inadequate drinking water and sanitation. From this sanitation problem, types of worms called soil-transmitted helminths (STH) are able to breed. The living conditions of poorer families and the subsequent poor sanitation increases the likelihood of being infected. Infection from these worms is chronic and widespread, harming children’s health and development as well as limiting their participation in school. To eradicate this problem, school based deworming has been found to be the most effective solution. For those reasons, I decided that the most effective way to ameliorate the health situation at BCS would be to initiate a deworming program at BCS. During the beginning months of my 11th grade year, I began to seriously consider taking on this project. In November, I decided that I would definitely follow through.
I first prepared a proposal in which I outlined my plan for the program. Once this proposal was accepted, I began my preparations. After fruitlessly contacting many NGO’s, the WHO, and organizations involved with deworming, I was finally able to reach the offices of Volunteer Partnerships for West Africa (VPWA), Catholic Relief Services/Ghana Health Services, and USAID Ghana. I arranged to purchase all 200 deworming tablets from Hayford Siaw, the Director of the VPWA and then set up meetings with him, Cynthia Omaboe (Ghana Alliance Specialist) and Felix Osei-Sarpong (USAID Health Officer) from USAID Ghana, and Dr. John Kwesi Marfoh (the Neglected Tropical Disease Coordinator) from Catholic Relief Services/Ghana Health Services.
Finally once everything was confirmed, during the 2013 February break, I travelled to Ghana with my mom to begin my deworming project. Once there, we stayed in Accra for 3 days to meet with VPWA, Catholic Relief Services/Ghana Health Services, and USAID Ghana. Each meeting was extremely helpful and I was ready to begin deworming at BCS.
The Wednesday that Team Ghana left the BCS campus, my mom and I arrived. That day, we spoke with the new headmaster, Barnabus, about logistics for the next few days. We agreed that the next morning we would hold an information session for all of the parents, deworm them, then hold information sessions in each classroom for each grade and then deworm students after lunch.
The next morning, we arrived at 8:00am set up tables under the tree, placed scales next to the table, taped the dosage poll on the tree and took both the albendazole and praziquantel out of their boxes to prepare for deworming.
After set up, I focused my attention on education. I first gathered all of the teachers in the 4th grade classroom and educated them about worms. During this session I talked to them about a few topics:
- What pills I am giving you and your students?
- What is the importance of administering the pills every year?
- What are the different kinds of worms and what do they do inside of you?
- What steps do you need to take to prevent worms in school?
- What are the effects of having worms?
- How do you know if you or a student has worms?
- What are the side effects of taking the deworming medication?
- How do the deworming pills help you?
After the teacher education session, I met with 80 parents and siblings outside by the tree. I was astonished but thrilled that so many parents were able and willing to attend because our expectations were quite low. In fact, I had originally expected 10 parents maximum. Again, we used Augustine to translate what we were saying into Twe because the majority of them did not speak or understand English. This session was quite similar to that of the one we conducted with the teachers. We covered the same topics but also reassured them that it is completely normal to have worms and that it is not because they are dirty people but rather because worms are everywhere and it is extremely hard to avoid them. We also discussed the importance of being a good role model for their children when it came to taking steps to prevent worms. With the help of Augustine’s translation, it was very successful and they all seemed truly appreciative of the project.
After the education session with the parents was finished, we began the deworming process. We decided that to be the most efficient, we would split each group up into two lines – female and male. The females would be dewormed by myself and Steven (the grade 5 teacher) and the males by my mom and Prince (the 4th grade teacher). However, before anyone could be dewormed, they would go to the dosage poll at the tree where Felicia (the grade 1 teacher) and the nursery teacher would take their height on the poll to see how many praziquantel tablets they would receive.
We began with the faculty and then the 80 parents and siblings that had travelled as far as an hour to come to school and meet us to be educated about worms and dewormed. The process was tough at first but after the first 20 parents or so, we were able to administer the pills quite smoothly. After being measured on the dosage poll by the tree, Stephen and Prince would write down the names, age and dosage for each person and I would give them the correct dosage of praziquantel pills and one albendazole tablet. They would then go to the bucket filled with water and use the cups provided by the school to swallow the pills.
Once the students had finished their lunch, we dewormed them class by class starting with nursery. This time, we also had to weigh the students so Barnabus and Augustine were in charge of telling Stephen and Prince the right weight. Because the younger students are not used to taking pills, it was also quite difficult to get them to chew and ultimately swallow the albendazole.
Following the deworming, I went to each classroom and had a more simplistic and interactive discussion with the students. I was able to talk to them about:
- How do you prevent worms?
- There are good worms and bad worms…
- What do bad worms do inside your body?
- What does it look and feel like when you have worms?
- What will the pills do for you?
During this session we used a lot of pictures to show them the steps to prevent worms as well as what it looks like to have worms. We also showed them pictures of what not to do. The last set of pictures we showed them were pictures of situations where you need to wash your hands either before or after. Finally, we showed them a picture of a child with a swollen stomach who had worms and explained what it felt like for that child and described how he looked.
The Baden campus has already agreed to sponsor this program as well as any other health related initiatives in the future. Thanks to them, there will always be funds for deworming pills each year and for continuing this project. This program will be continued each year and hopefully, one day, worms at BCS will be a distant memory.
Three Days out of Liza Lindgren’s Blog during her second deworming visit, February 2014:
Day 1: February 11, 2014
Today was our first day in Accra after landing last night. Ben and I had two meetings planned for the day: one with Dr. Marfoh from Ghana Health Services, whom I had met last year, and another that Ben had organized with Joanna, a librarian from the Kathy Knowles library. Unfortunately Dr. Marfoh could not make it to our meeting as he was called away to work in the field. However, he called me and provided me with all the information I needed. He had already organized for me to pick up the deworming pills from the regional health officer in Kumasi, Bernard Fori, and gave me the contact information for Mariam, the health worker for the local district in which BCS is situated. Additionally, he informed me that Mariam does not need a monetary retainer but in fact only needs compensation for fuel and meals on the day that she visits BCS.
When I got home, I then called Dr. Bernard Fori and arranged to meet him and pick up the medicine at around 1:30 tomorrow.
Day 2: February 12, 2014
Today we flew out of Accra at 11:00 and arrived in Kumasi at 1:00, just in time to meet Dr. Ofori. We arrived at the Kumasi airport and went straight to his office. When he arrived, he seemed unaware of our situation. He was under the impression that we were going to be arriving with the district health officer and that she would be the one to pick up the medication with us. He informed us that the way to get the medication was to go through the district health official directly; however we were not aware of this hierarchy needed to obtain the deworming pills. We gave him background information on BCS and he then invited us to talk to his supervisor so that we could get approval to pick up the medication. His supervisor was actually from the Bosomtwe region and was so impressed with the school and our work. He agreed to let us take the medication from their warehouse without the district health officer and we did so. We were able to acquire enough medication for 300 people – 300 albendazole tablets and 1,000 praziquantel tablets. The school only has 125 students and 8 teachers but I wanted to make sure that we had enough for parents and community members who could show up. This meeting took longer than we had expected so we could not get to BCS by 2:30 as we had planned.
We arrived at BCS at around 3:30 but thankfully, most of the students were still there because Team Ghana was doing a goodbye performance. We were able to greet the students, Team Ghana and talk to Barnabus about logistics for deworming the next day as well as Ben’s library project. We agreed to come at 9:00AM to meet the parents and both educate and deworm them.
At around 5:00PM, Bernard called and informed me that he had spoken with Mariam and arranged for me to meet with her at her office in Kuntenase at 8:00AM.
Day 3: February 13, 2014
Today was deworming day. We woke up earlier than usual so that we could arrive in Kuntenase by 8:00. When we got there however, Mariam called and informed us that she was still on her way to Kuntenase and would not be able to get there before 8:45. We had to be at the school by 9:00 so we decided to go straight to the school and send our driver back to Kuntenase to pick up Mariam.
We were able to arrive at the school at around 9:00 and when we got there, the members of the parents association and a handful of their children who were not yet in school, were waiting for us. We waited another 10 minutes for the rest of the parents to trickle in and then began the education session. I used the same material as last year with a few adjustments to the way in which I presented the information. For example, in order to make sure that parents were not offended when I told them to encourage their children to wash hands and wear shoes, I placed more emphasis on the fact that contracting worms was totally normal for children and that it was not because they had a dirty home or were dirty people, but simply because it is common for children to play in the dirt, put their hands in their mouths, and forget to wash their hands.
After this education session, we began deworming. Like last year, we divided the group into male and female. The males went to me, my dad, and a teacher from BCS while the females went to my brother, my mom, and another teacher from BCS. We set up two dosage polls on either side and had BCS teachers stationed at both to determine the appropriate dose of praziquantel for each person. The teacher at the dosage pole told me the dose and I wrote it down on the paper I had created for documentation. The person then approached us, the BCS teacher next to me took down their name and age, and then they made their way towards my dad who gave them the appropriate dose of praziquantel and albendazole. This system worked more efficiently than last year and we were able to deworm the parent’s association relatively quickly.
After they were dewormed, we moved on to the education and deworming of each classroom. We began with KG1 and KG2 and then came Nursery, Class 1, Class 2, Class 3, Class 4 and finally, Class 5. For the education sessions with KG1, KG2, Nursery, and Class 1, Eric, BCS’s English teacher, translated what I was saying into Twi so we could ensure that every child understood. With Class 2, 3, 4, and 5, no translation was needed and education went just as smoothly. Furthermore, like last year, the education sessions varied with each class according to their maturity level.