In July 2016, we sat down with veteran strategic planner Dana Letts, of New Mexico USA, to brainstorm our goals and vision in starting a non-profit. We had just finished our first healthcare mission, a dental mission that served over 300 people with free dental care. Our question was “how do we make healthcare in Ghana sustainable?” We completed the strategizing process with a mission, vision, and goals.
In August 2016 we officially became a U.S. non-profit organization and attained 501c3 status in September 2016. Since then, we’ve organized and led healthcare missions in October 2016, April 2017, August 2017, and October 2017. Since our first mission in June 2016, Healthy Villages, Inc. has provided totally free healthcare for 4134 villagers living in remote, impoverished villages in Ghana’s Volta Region.
We’ve been able to do this by bringing in volunteer teams of licensed healthcare providers from the U.S. and Canada to work alongside our Ghana-based medical team in an outreach setting. The volunteers make a “minimum required donation” to Healthy Villages which covers their in-country expenses and pays for our staff, medications, and our administrative costs. Their donation is tax deductible.
Providing free care to over 4000 people is quite an accomplishment, of which we are justifiably proud. However, we recognize that outreach missions do not provide a sustainable means of providing follow-up care and medication management. This is an area for continued development as we move forward into 2018.
HIGHLIGHTS AND LOWLIGHTS OF 2016 and 2017
Around the middle of 2016, a U.S. nurse advocacy organization called “Show Me Your Stethoscope” (SMYS) asked if we would be interested in leading a medical mission to Ghana. This was our first attempt at organizing and leading a team of volunteers – we had eight in all. Lisa Bowers, RN was an invaluable part of the team, who recruited volunteers, gathered donated supplies and meds, and kept everyone timely in meeting obligations pre-travel. Lisa is now serving on our board of directors and has taken on additional responsibilities. One of the volunteers was Jalil Johnson, LNP – also the national director of SMYS. He liked what he experienced and how we managed the mission, and asked us if we would partner with SMYS to provide missions to fulfill their philanthropic responsibility. In return, SMYS would donate money to Healthy Villages, Inc. to cover part of our expenses in operating the missions. Unfortunately, SMYS has had financial challenges prohibiting them from donating to us at the level at which they had hoped. They still serve as a resource for recruiting healthcare professionals, and we plan to continue our partnership with SMYS in 2018.
The October 2016 mission was our first mission as a non-profit. We served over 850 people – and we learned a lot. The mission was a great success, with the volunteers agreeing that they felt they had well-utilized their professional skills to make a valuable contribution to the poor and underprivileged. On our side, we took note of ways we would change some of our procedures to improve the next mission.
Our next mission was in April 2017. One of the big lessons from the previous mission was that we would need to require a larger “minimum required donation” to cover our expenses. Both of us co-directors had put significant amounts of our own money into organizing and leading the missions and it was clear that this was not a sustainable way to run the organization. Without outside donations, we would have to charge more to cover our expenses. We raised the minimum donation from $900 to $2000 and required a $200 deposit.
Co-director Sara recruited and organized the team of nurses through SMYS. Unfortunately, by the time the team was to travel, half of the team had dropped out for one reason or another, and we were left with four practitioners. This reduced our overall income but most expenses stayed the same or increased, the result being that we were still personally financially strapped when the mission was over.
On the positive side, we re-organized our on-the-ground operations to serve three villages for two days each. This allowed us to treat every person who came to us rather than having to turn people away at the end of the day. Along with our Ghana staff, we got our set-up procedure down pat so we could start seeing patients earlier in the day. We treated over 1000 people over six clinic days, including some very serious cases where our intervention likely saved lives.
Since May 2016, we had been in conversation with the Chief of our home village in the Volta Region and the Ghana Health Service director for our district about building an upgraded health facility in the village. All agreed this would be of benefit to the community and we had the seal of approval of the tribal elders. We got an estimate for building costs and started exploring options for funding the project. Unbeknownst to us, another member of the village Council of Elders who lives outside Ghana stated he would fund the building of the clinic. Unfortunately, for whatever reason he also stated he did not want to work with our organization. We were only informed of this development when we were already in discussion with serious funders and philanthropists, so it was a serious blow to us as an organization, and personally. There were other repercussions to us as individuals, and to our organization. Without going into details, suffice it to say, this was an example of tribal politics at its worst, and personally upsetting and degrading.
This project had been our main plan for creating a center for sustainable health care in the district. We are considering our next steps regarding sustainability as a focus, which will be outlined below.
In August 2017, we led a mission devoted to the care of children. We treated around 1250 children over our six clinic days. Our team of four practitioners included a dental hygienist, who saw the children experiencing dental pain. We had hoped she would be able to do more preventive care, but unfortunately our request for a grant providing free dental supplies didn’t come through. We had some supplies left from our first dental mission in 2016 which she used judiciously to help the children needing it most.
Lisa Bowers organized a vitamin donation through her church and workplace and collected over 100 pounds of chewable vitamins – more than could be transported in luggage to Ghana! Prior to traveling to Ghana, co-director Sara helped with repackaging the vitamins into small containers and then transported these and additional large bottles of vitamins. We also got a sizeable donation of the children’s deworming medication Albendazole through the organization, “Vitamin Angels,” for distribution to young children up to five years of age. Our volunteers brought clothing and books for donation – the clothing went to one of the village clinics to use as an incentive to get caretakers to bring the children in for preventive care, and the books were donated to “Dream Big Ghana,” an NGO that’s developing an education center in a small village in a neighboring district.
Again, we saw some very severe cases where the child should have been taken to the hospital long before we arrived. We had limited means to provide more than a round of antibiotics and pain reliever, a referral, and strong admonition to take the child to the hospital for ongoing care. In one case, we provided the money for payment and medication. We arranged with the local clinic nurse to manage the payment and buy the meds for the child. We later learned that the mother of the child never followed through when she learned that we wouldn’t give her the money directly, and was avoiding the nurse. This is one of many sad stories we’ve heard about the unfortunate state of healthcare in the villages.
All in all, this was our most successful mission in terms of numbers seen. However, once again we were left financially challenged, as our original team of eight again dwindled to four. As we planned for 2018 missions, we took our financial wellbeing into account and again raised our “minimum required donation” to $3000 with a $1000 non-refundable deposit.
In October/November 2017, we devoted our outreach mission to women’s health. We visited three communities – two remote villages, and one more-accessible health clinic in a town in our location. We had a team of four again – a doctorate level nurse practitioner from Canada and her 13-year old daughter, and two registered nurses from the U.S. We saw and treated a total of 650 patients – 590 females, age 10 and up, and 60 children that their moms had brought along and needed to be seen. We expected women to bring their sick children and we had medications on hand for them. After the huge number of patients we were able to serve in August, we expected to be able to treat a similar number of women – we quickly discovered this would not be possible. The women we saw had numerous health complaints and most had not been to a doctor. After the first day, we realized that we needed to shift our focus from “quantity” to “quality” and take the time to gather history and treat as many of the women’s problems as possible. We also decided to pre-register a set number of women at the beginning of the first day in the two remaining locations. This system worked perfectly, as only the women truly needing care came early in the day to be registered.
We ended our 2017 work severely financially challenged, having been able to meet our financial obligations to cover the cost of running the missions, with no additional funds for our work as mission organizers. This was the biggest challenge we faced in 2017. See “Financials” section below.
2017 ANNUAL REPORT FINANCIALS
In-kind grants and donations (medicines and supplies): $37,207.40
Monetary donations from private individuals: $1887
Monetary donation from Show Me Your Stethoscope: $2000
Monetary donation from Healthy Villages, Inc. co-directors: $5510.32
Volunteers’ payments (for 2017 missions only): $26,000
TOTAL MONETARY DONATIONS/PAYMENTS: $35,397.32
Travel (vehicle expenses, fuel, maintenance and repairs, staff transportation): $6598.06
Lodging and food: $6602.07
Staff salaries: $4067.52
Office and miscellaneous supplies: $2330.24
Administrative (co-directors’ combined income): $5552.38
All other expenses: $5510.32
TOTAL EXPENSES FOR 2017: $35,397.32
In 2017, Healthy Villages, Inc. received $37,207.40 worth of in-kind grants and donations of medicine bottles, over the counter and prescription medications and medical supplies, medical books, clothing, children’s books, and other items. Our in-kind donations came from private individuals, and in-kind grants from the non-profit organizations, Brother’s Brother Foundation, Vitamin Angels, and Project Hope.
Our monetary income totaled $35,397.32, primarily from volunteers’ minimum donation toward the healthcare missions. We had $1887.00 in monetary donations from private individuals and $2000.00 donation from our partner organization, Show Me Your Stethoscope. This income was used to cover the expenses for running three healthcare missions, as outlined above. Our administrative costs (e.g., co-directors’ income combined) totaled $5552.38. In addition, the organization incurred another $5510.32 in expenses (primarily travel back and forth to Ghana and other operational expenses such as phone and internet charges). These expenses were met through the co-directors’ donation to the organization, leaving their combined income for the year $42.06.
BREAKDOWN OF MEDICAL MISSION EXPENSES:
Lodging and food: 27%
Medicine and medical supplies: 19%
Staff salaries: 17%
Office and miscellaneous supplies: 10%
A few reflections:
Although our goal has been to improve the health status of poor villagers in our location of operation, our presence in the area impacts the economic status of numerous other individuals. In 2017, we added to the annual income of our staff of nine to ten people (Ghana Health Service personnel and cooks). We supported local businesses through purchasing medications, paying for lodging and fuel, etc. We also supported local merchants both by buying food and supplies, and by bringing our volunteers to make their personal purchases. As one of our volunteers noted, our organization should be welcome in the community not only for the direct service we provide in the villages, but for supporting the local economy as well. We are glad to be making a positive economic impact in poor communities and supporting local businesses.
We have seven missions on the calendar, three of which are “volunteer tourism” missions intended to be fundraisers for Healthy Villages, Inc. Our four “regular” missions are February/March (women’s health), March (dental/vision), July (pediatrics), and November (general health/diabetes). The volunteer tourism missions are August, October and December. We have an additional fundraising tour planned for August/September which will not include a mission or volunteer work; profits will go toward Healthy Villages, Inc. projects.
As of this writing, our women’s health mission has a solid group of eight volunteers. We’re hopeful we will fill all our missions in 2018.
Washable Sanitary Pads Distribution
As part of our February/March women’s health mission, we will be distributing 600 kits filled with washable sanitary pads, moisture-proof panty shields, underwear, vitamins, hygiene products, washcloths and pain reliever to schoolgirls in the poorest villages in our district. The products are being sewn by volunteers in Virginia, USA, organized by Lisa Bowers and her sister, Teresa Richards (both of whom are coming on the mission in February). The Ghana Health Service is working with the school health coordinator in our locations to decide which communities/girls will receive the kits, and two of our Ghana staff are working with our volunteers to prepare a culturally-appropriate educational program to cover menstruation, sex, pregnancy prevention, and women’s health. The girls receiving the kits will have the option to be treated for any health problems by our team as well.
We will be giving a short questionnaire as part of the distribution/education, to be repeated around six months later. This is a pilot project that we hope will help lower the rates of teen pregnancy, increase days in school and literacy, and improve self-esteem in menstrual age girls.
If the project proves to be worthwhile, our goal is to have the kits sewn in Ghana to provide jobs and income to local seamstresses, and to continue the project in other poor villages.
Community Sustainability and Self-Determination
Advocates for Community Alternatives (ACA) is a U.S. non-profit whose mission is to empower villages in West Africa threatened by destructive mining operations to develop sustainability plans and determine their own future. They currently have a pilot project in the Brong Ahafo region of NW Ghana. We will be piloting a project with ACA to bring their community-driven approach to sustainability to a village in the Volta Region that has been struggling against a mining company for the past eight years. This will be a long-term project and we believe the process can be taken into other villages as part of our organizational focus on sustainability.
ADDRESSING THESE CHALLENGES