Fight COVID-19 with ViVID
1. Introduction
In response to COVID-19, the Ghanaian government reacted quickly with preventative measures in comparison to many countries throughout Asia and Europe. Once the first positive case of COVID-19 was confirmed in Ghana, borders were shut down immediately and two of the largest cities, Accra and Kumasi were locked down by the government. Conversely, however, Ghana ended their lockdown very early compared to other countries and became the first country where lockdown was lifted in Africa. It is because the vulnerable, poverty ridden communities throughout the country could not withstand the lockdown.In April 2020, International NGO ViVID (Non-Governmental Organization Vivid Village for Inclusive Development) started an emergency project. This was to introduce preventative measures for the novel coronavirus in the rural community of Sekyere, Ghana after the community requested the organization for assistance. The project includes two phases: providing medical supplies for the Sekyere Health Center; placing portable washing-hand tanks around the community and distributing facial masks to all the residents in the community.As a result, both Phase I and II of the project were successful because since the project started no positive cases of COVID-19 had not been confirmed from the community. However, as time passed after the outbreak, new social issues started appearing in the community. All of the issues seem to be related to poverty to some extent, which the community has been suffering from.
2. Ghana's Response to the coronavirus outbreak
When the SARS-CoV-2 had gradually spread from Asia to Africa via Europe, the Ghanaian government had initially reacted quickly with preventive measures when compared with many countries in Asia and Europe after confirming their first positive case. On March 12th, 2020, they decided to close their borders just 5 days after two foreign tourists from Norway and Turkey tested positive. The Ghanaian government banned gatherings and closed all schools within one week from the first case discovered, while Japan’s government decided to close after about a month and a half from when the first case was discovered. Still, Ghana had more and more cases confirmed throughout the whole country; especially within the two biggest cities in Ghana, Accra and Kumasi, which both recorded a dramatic increase of positive cases of coronavirus. Eventually, Ghana’s government made the two cities lockdown on March 30th, 2020. It took only two and half weeks for the government to make a decision to lock down after they closed their borders.Ghana not only locked down their borders but has been aggressive in their efforts to get people tested to prevent the spread of the virus before the medical infrastructure can be overwhelmed. President Nana Akufo-Addo mentioned in a State of the Nation Address, “We have, till date, tested 68,591 cases. We are ranked number one in Africa in the administering of tests per million people”. (Presidency Republic of Ghana, 2020)However, surprisingly, despite the growing number of infected cases and the increasing rates of infection, the president lifted the three-week lockdown on the 20th of April and Ghana became the first country where lockdown was lifted in Africa.Why did he lift the lockdown in such a short period of time? It is because of a social issue that almost all Sub-Saharan African nations including Ghana are faced with but is not as severe in developed countries: poverty. With the informal sectors being a larger part of Ghana’s economy, the daily life in lockdown cities was unbearable for millions of poor and vulnerable people living on the edge.The Ghanaian government made efforts for vulnerable people during the lockdown. They actually halved electricity costs for Ghanaian people if they used more than 50kw/month. If they used less, they did not charge. They also cancelled water bills for three months and distributed hot meals and dried food supplies in the poorest areas suffering from poverty to ease the burden of lockdown. However, this assistance was not sufficient for all the population in Ghana. The earliest opening for lockdowns in Africa was a tough decision made by governments having to choose between saving people from the virus or from poverty. [The comparisons in the political measures between the Japanese and Ghanaian governments]
In terms of financial resource difference between the Japanese and Ghanaian governments, while the Japanese government offered the benefit of 100 thousand yen (around 900 USD) for each person in the whole Japanese population, in the case of Ghana, the government was not able to provide any money to support people in Ghana to overcome severe life restrictions brought about by the pandemic.Additionally, every medical facility in Japan had sufficient medical supplies for the minimum requirements for coronavirus preventative measures, even in rural villages. In Ghana those medical supplies were not sufficient, especially in rural areas, so what the government had to do as preventative measures was try not to spread the infection as much as possible. Their political response was to close their borders and lockdown the infected big cities quickly. They knew the most important thing is that the medical system in rural areas could happen to collapse in order not to be able to take care of not only the patients with coronavirus but also ones with other diseases such as malaria, which might cause worse situations.They knew the most important thing was to guard their medical infrastructure from overwhelming collapse caused by an influx of COVID-19 cases. This would cause insufficient supplies, beds, and care for not only coronavirus patients, but also people with other medical conditions.
3. Situations in Sekyere community before the outbreak of COVID-19
When the confirmed cases of COVID-19 almost tripled after the lockdown was lifted, International NGO ViVID was tasked to aid in preventative measures by supporting the community of Sekyere in Ghana. Neighboring Sekyere, in the town of Effidause, two positive COVID-19 cases caused panic throughout the community which did not have any preventative measures against COVID-19 at that time. So, the community requested assistance and my NGO urgently started preparing for the project “Fight COVID-19 with ViVID ‘’ as a means to tackle the impending emergency. The following is important background information about the community of Sekyere from the 2010 Population & Housing Census, District Analytical Report published by Ghana Statistical Service. Sekyere has a populace of 5,000 citizens and is a small rural community near the second biggest city in Ghana, Kumasi, the capital city of the Ashanti region. The third largest region of the 16 administrative regions in Ghana and famous for being the birthplace of Kofi Annan, who was Secretary-General of the United Nations from January 1997 to December 2006 and who received the Nobel Peace Prize in 2001. Sekyere became a partner community of my organization upon its formal establishment in February 2020.Also, the census states that about 80% of the population of Sekyere-Kumawu in the Ashanti region, rely on agriculture as their main form of subsistence. Most are crop farmers, with the most popular crops in the region being yam, maize, plantain, and rice. About 35% of farmers also own livestock. Chickens were the most common livestock. Some farmers also kept goats, sheep, turkeys, and pigs. More or less, Sekyere also follows this static data.In the Sekyere community, there are the following public sectors: three combined primary and junior high schools, one junior high school, and one medical clinic administered by midwives and nurses (without medically qualified doctors). All the workers in those sectors, such as teachers, nurses, and midwives, are from outside of Sekyere.In terms of the geography of Sekyere, the community is isolated from other neighboring communities, with the larger town of Effiduase near the capital of the Sekyere East district. Most people from the nearby communities, such as Banko, Akrofoso, Oyoko, and Dadease, come to Sekyere to either buy or sell on Friday, the market day when the town usually gets busy. Although Sekyere does not have a large-scale market, people from those villages visit year round; The number of the visitors may range up to 250 people on Friday and 50 people on regular weekdays.There are no above ground flowing water systems in Sekyere, and the local people only have access to three wells. Therefore, washing their hands regularly has never been a part of their daily routine. This makes them more vulnerable, since washing your hands is one of the most important preventative measures for the coronavirus infection according to the WHO.Also, because most of the population in Sekyere are farmers living hand to mouth, they are unable to afford the purchase of facial masks, although the Ghanaian government requires people to wear facial masks by law. Almost none of the locals walked the streets wearing facial masks before our project started.If we took a look at the situation of the Sekyere Health Center, none of the medical staff could follow any preventative measures. They did not wear any protective gowns, goggles, surgical gloves, or even facial masks. It seems that the medical staff had taken care of patients, who were suspected to have coronavirus infection, without any protection.
4. About Sekyere Health Center
Sekyere Health Center (SHC), which International NGO ViVID supports, is the only public health center existing in the community of Sekyere, Ghana. It was founded in 1997 under the supervision of American peace corps volunteer Lisa De Lindsay, and funded by the Embassy of Japan. Lisa De Lindsay researched the community and made her decision on what the community needed most, which was a medical facility and wrote letters to embassies to ask for support for the community members. Finally, the organization that she belonged to was able to agree with the Japanese Embassy to receive financial support and provide labor force as an exchange.
In March 2020, International NGO ViVID sent one member to the community. The head midwife of the SHC, Ms. Rosina Asyeiwae, answered questions about the roles of the SHC in Sekyere and issues facing the community. The clinic has greatly benefited the community. Before building the SHC, there were not any other medical institutions and community members in Sekyere were required to drive to Effiduase, a community neighboring Sekyere, for medical service and delivery. Now the community members can receive basic medical services and give birth at the clinic. As of March 2020, the clinic was administered by 12 medical staff, including midwives and nurses, dispatched by the government. The staff, therefore, must change where they work after their assigned period, but every day they contribute to health services for people in Sekyere.
Common diseases that patients in Sekyere have when visiting the SHC include malaria, hypertension, and upper and lower respiratory diseases. They also come for deliveries and check-ups. In terms of the number of patients with malaria, there were 916 patients in 2019 alone. Regarding HIV/AIDS, there were two AIDS cases in 2019 according to a report from SHC. The center provides education about AIDS, and most of the people have correct knowledge of AIDS according to a midwife of the SHC, Rosina Asamoah. Ms. Asamoah mentioned that patients with neurological disorders, like epilepsy, do not go to hospitals. They are treated through spiritual methods, so they do not visit the clinic. It was interesting to know that spirituality is one of the trusted treatments for health problems. The program for prevention with vaccines was established and is always available, according to Ms. Asamoah. The Center also provides education for people in Sekyere to raise awareness of the necessity of vaccines. Expecting mothers participate in the regular check-ups before the delivery program. In 2019, there were 80 births at SHC. For the medical insurance system in Ghana, after the first registration, a person needs to renew every year with a renewal fee of 6 cedis for 1-17 years old and 26 cedis for 18-69 years old. For people aged 70 and above, medical insurance is free. Depending on one’s sickness, insurance covers the cost. (Ghana Health Service, 2019)
Ms. Asamoah says that the shortage of medical supplies must be resolved as soon as possible if they are to continue their important work. She also mentioned that all the data was kept on paper, and it seemed troublesome to organize and manage diagnosis and data. The center sends the papers to the district where they are digitized, but it would be more efficient for the clinic to put information on a computer. This would not only reduce the work of staff, but also allow them, or other entities, to use the information for analysis.
5. Outline of the emergency project for coronavirus preventative measures: Fight COVID-19 with ViVID
This chapter entails the project outline for coronavirus infection prevention measures for the Sekyere community. We named this project Fight COVID-19 with ViVID, and it is divided into two phases.
Phase I
In phase I of the project, we provided facial masks and gloves to the medical staff working for the Sekyere Health Center and sufficient medical supplies to prevent the infection. If the medical staff was infected, the center’s administration would stop running due to a lack of available workers This would cause the community to lose all medical services since SHC is the only clinic in the community. Not only would this cause the unmitigated spread of coronavirus, but it would also impact other patients depending on the center.
Phase II
In Phase II, we set up 13 veronica buckets, which are simplified hand washing tanks. We also distributed facial masks for all the community members who are above two years old. According to the WHO’s preventative measures and the coronavirus’s characteristics, it is important for all the community members to wash their hands and wear masks. Unfortunately, in Sekyere, there are no above-ground flowing water systems, and people could not afford to buy facial masks. Therefore, we needed to place simplified hand washing bottles and distributed facial masks for all the community members.
6. Phase I of the project
In phase I of the project “Fight COVID-19 with ViVID”, $200 USD worth of donations were collected from an official website of International NGO ViVID and sent to the Sekyere community for the purchase of medical supplies for the SHC. The SHC was founded by Japan’s Official Development Assistance. They provide regular checkups for residents in Sekyere, as well as, medical treatment for patients with malaria, respiratory infections, and midwifery. The Sekyere Health Center is the only medical agency in the community. In the current outbreak, the clinic plays a central role in the prevention of coronavirus in the community. However, the health center has limited financial resources and is unable to afford essential medical items for health care. So ViVID decided to, firstly, support the health center to allow them to continue normal medical activities, and play a central role in coronavirus preventative measures for the community. Secondly, they are going to offer some preventative items such as facial masks directly to the community as soon as possible. In this phase of the project, we collaborated with all the midwives and nurses working for SHC to save Sekyere people’s lives from COVID-19. The medical supplies that ViVID had donated to SHC during the first phase include:
· Blood glucose meters
· Blood glucose test strips
· Disposable hair nets
· Methylated spirits
· Kitchen towels
· Hand sanitizers
· Surgical sutures
· Envelopes (for package drugs)
· Bandages
Furthermore, as well as the basic medical equipment above, 35 masks were supplied to the most vulnerable residents in the community. The first set of 12 facial masks were distributed to pregnant women who came for antenatal care without wearing facial masks. The rest of the masks were given to the elderly and taxi drivers.
7. Phase II of the project
In phase II of the project “Fight COVID-19 with ViVID”, we did crowdfunding, beginning on May 16th, 2020, to collect donations and provide Veronica buckets and facial masks to residents of Sekyere, Ghana. We aimed at collecting 300,000 yen (around 2,500 USD), and thanks to the heartwarming support of many donors, we raised 332,500 yen (around 2,700 USD). As a result, we sent 13 Veronica buckets and sewed and distributed about 900 facial masks to people with preexisting conditions which gives them a higher chance of getting the virus. This includes the geriatric community. After that, tailors in Sekyere worked hard to finish sewing masks so that the rest of the community from ages 2 to 49, about 3,700 people, could have their own mask after having to live without one during this pandemic. In addition to the material support, ViVID advocated raising awareness of taking appropriate measures against COVID-19. Initially, we planned to distribute an illustrated instruction card to each household. However, we got an idea from an active volunteer in the community to broadcast the information by using a public audio speaker in the village. A low literacy rate is one of the key challenges in the community, so in order to include all residents of the community, the audio announcement was the best way to spread the information. The safety information was broadcasted each morning and evening for 6 days over the course of two weeks. The contents included the following:
- Avoid the “Three Cs” (Closed spaces, Crowded places, and Close contact settings);
- How to wear and take off the mask correctly;
- What to do when you feel unwell
ViVID is operating with our 3 pillars in mind: Inclusion, Participation, and Partnership. By using the pillar Participation and taking community members' suggestions into account, we were able to ensure no one was left behind. In total ViVID has provided 13 Veronica buckets. These handwashing facilities are set up in locations where members of the community have easy access, including right outside the village gates. In rural areas of Ghana, where infrastructure is inadequate, households do not have access to running water. The Veronica bucket was invented to enable people to wash their hands with running water and soap. It is named after the inventor and biological scientist, Veronica Bekoe who has worked in the field of an experimental medicine for 30 years. She led a national HIV/AIDS program and served as the head of the National Public Reference Laboratory in Accra, Ghana. When she was visiting rural communities, she was concerned about poor hygiene due to a lack of running water. Although she had tried to fix a tap, it didn’t work. Then, she came across the idea to make a handwashing facility that does not require running water. Other medical institutions who had the same issue adopted Veronica Bekoe’s idea, and it soon spread to restaurants and households. Now, the Veronica bucket is not only used and produced in Ghana but all over Africa. The Veronica bucket is very easy to set up. You pour water into the bucket, which has a faucet and lid and then put it on a wooden or steel stand. Then, put soap on the stand and a tray beneath the faucet and it is ready to use. It is a little work to pour water, but it is such a revolutionary product. It allows people to easily wash hands with clean water when they typically would not be able to.
Locations where we set up the Veronica buckets around Sekyere:
1) Zongo (Mosque)
2) Market
3) Taxi station
4) Church
5) Sekyere Health Center
6) Kootia block
7) Jackmoro block
8) Anansekrom block
9) D/A School block
10) New town block
11) Panin Alhaji
12) Ammantem
13) Ahenbronom
We also distributed 4,649 facial masks for all community members of Sekyere above 2 years old who needed one.
8. Final reports of the project
International NGO ViVID believes that Inclusion, Participation, and Partnership are crucial to achieving project goals. Therefore, we follow these fundamentals for all projects, including this fight COVID-19 with ViVID, to increase efficiency and effectiveness. This chapter will cover how the ViVID achieved all three ideals in the COVID-19 preventative measure project.
1. Inclusion
A. From the perspective of “No one left behind, including vulnerable people”:
a) We provided handwashing (by the placement of 13 Veronica buckets) and Facial masks to all residents in Sekyere
b) We hired all the tailors in Sekyere for facial mask production
c) We advocated for coronavirus preventative measures for all the people in Sekyere to help them understand how they can overcome the outbreak in their own language.
B. From the perspective of “Inclusion of all community members having an active role in the project!”
a) Facial mask manufacturing by all the tailors in Sekyere as players of the project
b) Distribution of the facial masks by volunteers from the Sekyere community
c) Management of Veronica buckets by volunteers from the Sekyere community
C. From the perspective of “Inclusion of a diverse of stakeholders as active members in the project”
a) Fundraising from people around the world via website and SNS
b) Conducting crowdfunding both in English and Japanese to raise funds from all over the world
c) Financial support from old volunteers who supported the community in the past
d) Exchanging advice with other Ghanaian NGOs about the production of facial masks under the coronavirus outbreak
2. Participation
a) The medical staff in Sekyere Health Center inventoried all emergency medical supplies by themselves (Not with instructions from the ViVID)
b) Volunteers living in Sekyere place the Veronica buckets in the most effective sites by themselves
c) Volunteers who grew up in Sekyere were selected as the most suitable people for managing Veronica buckets
d) Volunteers made a plan for the most efficient process of production and distribution of facial masks by themselves
3. Partnership
a) The whole project was conducted as a joint project between ViVID and Sekyere Health Center. In order for this project to succeed both organizations had to complement each other’s strengths and overcome each other’s weaknesses.
b) ViVID’s strengths are fundraising and public relations, but they were limited by the restricted international borders between Japan and Ghana. This made it almost impossible for them to send the human resources needed for the coronavirus outbreak.
c) The Sekyere Health Center showed strength in their knowledge of the community and situation which helped them create a project plan that suited the community well while utilizing their limited financial resources.
The WHO formally made a declaration for a Public Health Emergency of International Concern (PHEIC) from the end of January 2020 until the 20th of October 2020. It is fortunate that, currently, the Sekyere community has no infected cases. Medical staff in the Sekyere Health Center are following the coronavirus preventative measures and people in Sekyere are wearing facial masks outside. Residents are also washing their hands with Veronica buckets when it is necessary. But most importantly, the people of Sekyere collectively took initiative for this project from the beginning and continue to stay vigilant throughout.
9. Worsened and new social issues that the outbreak brought to the Sekyere community
1. Poverty:
· Poverty can be defined as a state or condition in which a person or community lacks the socially acceptable essentials and financial resources for a minimum standard of living.
· Although almost all people in the Sekyere community suffered from poverty even before the coronavirus outbreak, the situation has been worse during the outbreak. The government locked down the two big cities, Accra and Kumasi, to restrict people from migrating to stop spreading the infection easily.
· Some people in the Sekyere community who usually sold their agricultural products in the market of Kumasi could not earn income during the lockdown.
2. Education and gender issues caused by poverty:
· According to a headteacher of 13 years at Sekyere D/A Primary School, education in Sekyere has improved over the past 10 years. This is because the Ghanaian government has been supporting educational funding at all levels, and parents are beginning to understand the importance of education. Now, theoretically, students can enjoy free education from primary school to senior high school. Some students are also trying to go to universities, training colleges, and nursing colleges.
· However, in the Sekyere community, there are still many students who drop out of school before going to senior high school. A major hindrance is financial constraints. Most of the students are trying their best to reach the apex of education, but because of poverty, their dreams are shut down.
· This lack of education as well as intercourse without contraception leads to some female students getting pregnant and being unable to complete their schooling. Thus, the rate of female dropouts is higher when compared to males.
· There is a relationship between early unplanned pregnancy and poverty since most parents are poor and unable to buy contraceptives. Most parents push their daughters into an early marriage due to the expense of bringing up children.
· With the coronavirus outbreak, the number of early pregnancy cases has increased according to Sekyere Health Center, because all the schools have been closed during the outbreak and the children have more spare time.
3. Unemployment issues caused by poverty:
· Poverty indirectly causes unemployment issues. According to the chief of Sekyere, although there is no official record, it is said more than 1,000 unemployed people can be found in the Sekyere community. This means approximately 20 percent of the population is unemployed. Almost all of the unemployed people did not receive sufficient education and worked hand to mouth as temporal farmers.
· The chief said most of the unemployed people are youths, although the people include a wide range of ages from 15 to 65 years old. After the coronavirus outbreak, those vulnerable people are suffering from poverty even more due to job scarcity. Even farmers cannot afford to hire some people since the market was closed because of the lockdown.
4. Stealing caused by poverty:
· Additionally, in the Sekyere community, several cases of livestock theft were confirmed. They were often conducted at midnight when everybody was asleep. With fewer jobs in the community and such extreme poverty youth frequently involve themselves in stealing.5. New social issues that the outbreak brought to children:
· Archibold Collins Oppon is a headteacher of Sekyere Methodist Basic school. He pointed out that students in Sekyere these days have resorted to alcohol and drugs, such as tramadol, and stay out late at night which may result in students sleeping with each other. Because of the coronavirus outbreak, all the schools in Sekyere were closed. Children had plenty of spare time, so the situation became worse compared to before the coronavirus outbreak.· Mr. Archibold suggested that we can manage these problems by providing entertainment centers. We can engage kids with activities, such as football, and also provide ICT training centers.
10. Possible solutions for the new social issues that can be suggested as an NGO
As of October 20, 2020, there have been 47,461 confirmed cases of COVID-19, including 46,752 recoveries/discharges and 312 deaths in total, according to Ghana Health Service. Also, 89 new cases were reported, and 397 active cases were observed throughout Ghana.
If the situation explained in the previous section is prolonged, the problems will become more severe. Also, the Sekyere community will require additional supplies of soap for veronica buckets, more medical supplies for COVID-19 preventative measures, as well as poverty aid. Therefore, as Phase III of the project “Fight COVID-19 with ViVID”, fundraising is on the official website of International ViVID to support the community until COVID-19 in Ghana is eradicated.
For poverty measures, agricultural projects will be launched for the next agriculture season in early 2021 in the Sekyere community. ViVID will buy some agricultural fields to hire unemployed people and increase the number of harvested crops. More employment ideas include producing new products from those crops, such as shampoo and soap.
Generally speaking, the social issues that the rural villages in Africa have do not originate from a single cause, but from multiple factors, such as follows:
o famine/poverty
o unsustainable agriculture
o environment problems
o bad sanitation
o bad health care/social welfare
o water/nutrition issues
o poor education
o gender inequality
o energy issues
The Sekyere community also suffers from social issues caused by multiple factors listed above. Therefore, to solve these issues, ViVID will start building a “ViVID Village”, which has the following three functions:
A. Community Support:
We will operate the multipurpose center in our supporting communities and will be open for people from any background. This will include facilities such as a library, an ICT room, and a seminar room.
B. Development Research and Analysis:
We research and analyze the problems that the communities are facing in each field (such as famine/poverty, water/nutrition, education, sanitation, health care/social welfare, gender, agriculture, environment, and energy) and use the results in “One Team Project” for community development.
C. Global Partnership:
We pull together diverse stakeholders (such as individuals, NGOs, private enterprises, and institutions) into “One Team,” to work for community development as One Team Project. The One Team Project will start in August 2022. In the Sekyere community, ViVID is going to partner up stakeholders who have been solving social problems in different regions and development fields with various skills and experiences, and we will all work together multilaterally and strategically for community development as One Team.