Circumspect interviews Maame Sampah and Emmanuel Lamptey, Executive Board Members of the Representatives for Equal Access to Community Healthcare (REACH) Ghana to find out how they got started, what projects they’re currently working on, and what they’re looking forward to.
Circumspect: Tell us about yourselves.

Maame Sampah (M.S.): I’m currently a graduate student. I’m with an HIV group right now, and so I basically do HIV research. Before then, I did undergrad in biochemistry and French at Grinnell College. I’m doing grad school at [Johns] Hopkins now. I went through the Ghana education system – Wesley Girls, Bishop Bowers before then. I can give you the name of my nursery school. And yeah, so here I am. I’m going to be in school for a while, and basically I’m going to end up in a career in clinical and research medicine. I have a huge family, I have four siblings. My parents both live in Ghana. My siblings however are kind of scattered in the U.K and here [U.S.] and in Ghana. And, I guess my interest in healthcare probably came from my mum who is a nurse. I grew up playing with medicine at home. I don’t know how it happened. I mean I actually didn’t set out; I went to college thinking physics major, chemistry. It was always something “sciencish” but I didn’t really head out towards healthcare until I did some college internships in hospitals and I loved them.

Emmanuel Lamptey (E.L.): My name is Emmanuel Lamptey, I’m also a graduate student right now. I have a masters already in diplomacy and international relations; specialization in global health and human security. So that’s my interest. Specifically my research areas have been in OVCs (Orphans and Vulnerable Children) and HIV/AIDS. Right now I work for a non-profit in D.C. in the programs department on a USAID funded project. I was born and raised in Ghana, came to the US for my undergrad and grad school. I have two younger brothers and my parents are both in Ghana. My interest in health, and I think that’s what I want to do, I see myself with a career in public health and global health. My interest peaked – because when I was younger I was more interested in international relations and politics. But in grad school, my thinking and my formative ideas about what I wanted to do with health started with the breakout of the HIV/AIDS pandemic in Africa. For me it was linking health with politics and the politics of health. So that’s what spread my thinking, so that’s why I’ve been interested in health stuff.
[Photo Insert: REACH Board Members Emmanuel Lamptey & Martha Sampah]
Circumspect: Where did the idea for REACH come from?
M.S.: The idea for REACH came from BarCamp. We basically went for BarCamp [July 2009]. I had actually attempted to go to BarCamp in Ghana before; it didn’t work out. But we went to BarCamp not really sure what to expect, and we went and basically started a breakout session on healthcare in Ghana. And it turned out a lot of people were interested in that. We spent about an hour or maybe a little bit over an hour bashing the healthcare system in Ghana hardcore. And yeah, there was a lot that people had to say about what was going wrong, but people also noted there are all these improvements being made. In the end what it came to was everybody chipped in at the end about what we could do specifically to help. I mean there was a long list of suggestions about specific things that we could do at our stage to help somehow. After BarCamp, a couple people who had been in the discussion got to emailing back and forth. We also had other contacts that we knew were very interested in the cause, and that ended up with a group of nine of us who have since then been planning this from the get-go.

Circumspect: Can you tell me a bit about REACH – what your aims are, where you see yourself within the next two to five years?
E.L.: Well, there are several things. I think our overarching goal is to be a part of the discussion and be a part of the solution. So, our idea is to influence, contribute and assist in the Ghana government’s effort to improve access to healthcare and quality of healthcare for Ghanaians. So we work through various engines. One of them is being a forum for networking of ideas and programs, of organizations that are interested in health projects. That’s one thing that we do. Education is another part, and not just focusing on the macro level; from the micro level to linking individual students – here in the U.S. and in Ghana – to network and bridge and bring ideas together.

Thirdly, it’s through programs and initiatives; be it a book drive, be it an HIV/AIDS project, be it research opportunities. So people, professionals who have ideas about how to improve the healthcare system, if they have ideas about how to do research, the government of Ghana wants to implement a research opportunity or research into a specific area. Being able to be a source or an organization that can either help facilitate that process or take part in that process. To actually do that research, so that we can bring out sustainable results. That’s our big thing. Our big thing is working with individuals, working with governments, and creating sustainable projects that lead to our overall access to care and improved access to care.
M.S.: You mentioned in two years, where do we see ourselves? I guess, part of the whole premise of REACH was really to bring people together. I mean, I can’t believe how much we’ve gotten done in the past six months just by virtue of the fact that there was a bunch of us who were working towards the same thing. None of us individually could have accomplished any of this on our own. That’s the point, you know, to create all of these opportunities. Basically what we see in two years, hopefully, will be that REACH will be a place where people interested in healthcare and doing a project in Ghana, will come, you know, just to get other people to help them on those projects. Be it in the planning, finding funding, the execution, program assessment, and whatever it is that they need. Basically, the point is, we’re pulling together all these resources so you can go to one place and not have to be running all over the place.

Another thing that we talked about is the fact that volunteerism is such a big thing in the U.S. That’s what we’ve all learned from being here. Going to a liberal arts college, Emmanuel and I both went to liberal arts college, it’s just such a big thing; public service. Everybody does it. It doesn’t happen in Ghana. I mean, the only thing that I can think about is National service, which is almost mandatory, you have to do it. People only do it because, well, I don’t know what people’s individual motives are, but it’s almost as if everybody does it because you have to do it. Here’s the case where people from the time you’re in middle school, high school, you know [about] service. That’s what we’re trying to encourage as well.

E.L.: Yes, creating service-oriented communities.

M.S.: So that at the end of the day, a high school based in Cape Coast is taking care of the Cape Coast community. We’re hoping that’s what’s going to happen. That REACH is going to be an organization that’s really run mostly by volunteers. We understand that there are going to have to be paid people to facilitate the whole process, but really, mostly run by volunteers. Be it volunteers from Ghana or study abroad kids from the U.S., whatever it takes; just people who are willing to put in something. And that’s how we’re planning on cutting costs.

E.L.: One of the things that we [the executive board of REACH] actually talked about when it came to our programs is building communities to be sustainable in giving them the capacity-building skills and techniques to be sustainable. A lot of the commentary on health care, not just in Ghana, but in developing countries is, what can the government do? What is the government doing? What about – what are the communities doing? And what kind of skills can the communities have so they can be sustainable so it’s not the government of Ghana building a university or a hospital in Swedru, but organizations in that community having the skills, the know-how, to raise money to build that hospital. A lot of the hospitals in the U.S. are not controlled by the government. They’re hospitals that were built to feed the need of the communities and are thriving based on the income tax, the kind of money you raise. So we’re trying to create the self-help part of it. So every program that we do, or will do, has a capacity-building sustainability part of it that is integral to our mission.

M.S.: Yeah. Actually an example is right in my own backyard. Hopkins, where I go to school, is purely the product, and it’s easily ranked one of the best hospitals in America. It was the product of one merchant. I mean it came from somebody’s foundation. But it was basically somebody in the Baltimore community who started Hopkins. There was a hospital that was built for African-American kids who didn’t have access to regular hospitals, and that’s kind of how it started. And then, after that, more funds were donated. But then it was people in the community who really, pretty much built it up. I understand, you do need a huge funding source for such a large scale project, but at the end of the day, I haven’t seen it in Ghana. I haven’t seen an individual or a group of people come together. Korle-Bu is government-owned, from Kwame Nkrumah’s time. And that’s what everybody depends on. Okomfo Anokye, same thing. All the major hospitals in Ghana, somehow, are just the result of the government. I mean, the point is that it’s time for us to step up and do something for ourselves.
[Photo Insert: Martha and fellow board member Aida Nana Ama Manu with REACH Advisory Board Member Dr. Ana Hitri.]

E.L: There are not enough Nyaho clinics; there should be more Nyaho clinics, more individuals. And it’s not so much that people don’t have the skill set or the money to do it, it’s sometimes, they don’t have the vision or there’s not the right atmosphere and maybe infrastructure, legal rights and privileges that are given by the government. Those are some of the things that REACH is more interested in as well. We’re not just talking about building those projects, but also advising and creating opportunities, and encouraging the government to provide the legal framework for people to be innovative.

Circumspect: Where did the name REACH come from?
M.S.: Oh, REACH. Ha! Brainstorming. Hardcore brainstorming. It was hard. We thought about it. We knew we wanted some kind of an acronym. We wanted something that people could remember easily. And, I guess it ended up being, we knew it was going to be REACH almost, just the whole concept of reaching out, which is what it’s all about. And then, we were thinking letters, and we were thinking community, healthcare, advocacy, excellence, excellent healthcare. I mean, we were thinking all kinds of words. And somehow it just kind of came together. You know, this is what we are: representatives of this cause that we’re committed towards. It just strung together, and it was just, ah, perfect, that’s what it was meant to be from the beginning. Yeah, we were really excited about that when we figured it out. The whole concept of reaching out and it standing for essentially what we are and what we represent.

E.L.: And reaching out from both ends. That was the big thing. It was not just us reaching out to communities in Ghana, but communities in Ghana also reaching out back to us and to themselves. The idea was creating an area for connection, where people with like-minds or visions can come together.

Circumspect: Would you like to give an update on what you’ve done so far?
M.S.: Okay, so far we’ve filed an article of incorporation which is just to say we’re an organization that exists in [Washington] D.C. and we’re in the process of applying for NGO status in D.C. and in Ghana. So that’s basically what allows us to take grants and donations, and it being tax-exempt. So we’ve been basically getting out organization together, trying to recruit members, trying to set up little committees, getting our first couple of projects going. December is the month that we chose for our launch. We started out with an HIV/AIDS project mostly because that was a common interest a lot of us on the board had. We were also in touch with Benedicata [Osafo-Darko ] who comes from an HIV background who was very excited about doing an HIV project. So that’s what we started with.  We chose December for our launch because that’s when we felt we were about ready to start the nitty-gritty of getting things done. And that coincided with World AIDS Day on Dec. 1st, and we thought, perfect, let’s do that. So far, we have two projects going, that is mostly being run by the executive board. We’re looking for people. So far we have members who have expressed interest in starting their own projects. Yeah, as many projects as is within our control, we’re ready to take on at this point. And hopefully our launch this whole month over here, and in Ghana and the U.K. will bring some results where we should have a couple more going. As of now, REACH has its executive board of nine, an advisory board of eight members – all this information is on our website – and we have a general membership of approximately 35 to 40, right about now. That was before tonight [Dec. 11], and tonight has been really great. Good stuff.

E.L.: And we have a book drive project. The books have actually been sent to Ghana. It was work by a couple of our executive board members, who already had this plan going before we officially formed REACH. So the idea was, they were able to get donations, and raised money to get textbooks to send to the medical school in Ghana.

M.S.: There are some books that are already in Ghana, we’re still soliciting for more. The point is there are certain books that you just can’t do without. Reference books for example, you can’t have reference books be outdated. And that’s what you see in a couple of the universities in Ghana. It’s not that they’re no good if they haven’t been updated, but if a book is ten years old, there’s so much information, I mean, just coming from a research background, you find out so much in a year in one field, that in ten years you’re missing so much. We thought that that would be an easy contribution.

E.L.: Yea, adding to the catalogue of materials that we already have. We’re not saying that Ghana doesn’t have any books; we’re saying that the more access, the larger access and a wider range of access to textbooks and research is better. More is better, that’s the idea.

M.S.: Related to this book drive project is also a web portal project that we’re planning, where it’s going to be basically a portal where health students and professionals in Ghana and over here, will have access to different kinds of information. So for example, students in Ghana should be able to access, you know, all the basic scientific journals and databases available. If somebody is a medical student in America and has a question about a tropical disease such as malaria, that is not known about as much, they can easily send a message to this portal, and a student in Legon [University of Ghana] should be able to pick that up and say, hey, this is what we know about malaria here. Same here, if there is a question about rheumatoid arthritis, which people might not know much about in Ghana, then they’ll do that. We’re thinking that should apply to not just medicine, nursing, psychology, public policy, whatever it is, basically making use of technology to make the exchange of information that much easier.  
[Photo Insert: REACH prospective member holding the REACH membership Form.]
Circumspect: What do you think Ghana’s key health issues are, and what recommendations or hopes do you have for overcoming them?
M.S.: Ooh, that is a hard question. I mean I can tell you what some of the key health issues are, but recommendations; that would take a textbook. Okay, malaria is still a serious issue, which is sad almost. Because, I mean, people can’t even afford malaria medication, or if they have malaria, if you’re in a really rural area, you don’t even know what it is you have. You can’t even go to a hospital because there is no hospital right there. Yeah, malaria is one of the big killers in Ghana. And it’s getting more complicated because the more this problem goes on, there are strains of malaria that are becoming more resistant to the medications that are available. So, the more people are getting infected by malaria that can’t be treated, the more of a killer it’s becoming. HIV is another problem, I mean; it’s not as bad in Ghana as other areas in Africa.

E.L.: But that has been because there’s been a saturation of, and an influx of money, sponsors and donors in education on HIV/AIDS. So that’s a success area of showing that if you have the infrastructure, the commitment, the money and the education, you can have success. Those four things are very important. If you generalize that to the Ghanaian healthcare system, I think that’s the big issue: commitment, the money, the education, and competent people running the system.

M.S.: I agree.

E.L.: You should be fine, because you’re providing the groundwork for people to be innovative. Healthcare should not just be a top-down approach, it can also be a bottom-up approach, but if there’s no infrastructure to allow that to happen, there’s no money to allow that to happen, there’s no competency for that to happen, and there’s no commitment for that to happen, it’s just a recipe for disaster.

M.S.: Yeah. And I mean, of course, that’s part of the reason for REACH. We’re still trying to put our heads together to think. There are models that have worked in other parts of the world, but what’s going to happen is that we’re going to have to come up with our own way for how healthcare is going to work in Ghana. And that’s why we’re together; we’re all still learning from each other, learning from our older advisory board people, whoever it is. It’s good, it’s a learning process for all of us, and hopefully we come up with something great in the end.

E.L.: We’re definitely not claiming to be the know-all, be-all of everything. What we’re doing is presenting our self as an instrument for use for contact and an instrument where people with like-minded ideas and visions can come together.
[Photo Insert: REACH executives and members at the organization’s happy hour networking event on Dec. 11.]

M.S.: We’re basically saying, everybody come. Let’s brainstorm, let’s figure this thing out, let’s get it down.

Circumspect: Any last words?
M.S.: Join REACH. And it doesn’t matter; you don’t have to be from a healthcare background. Actually on this executive board, there are only some of us that have healthcare backgrounds. Obviously you need technology, like we said we’re trying to make all of these projects sustainable. You need marketing tools, you need all kinds of different things. I mean, I can’t think of what discipline I can say is not relevant to what we’re doing. Bennie is a sociologist, that’s part of what we’re doing on this HIV project; trying to figure out what the social premise behind higher HIV prevalence in Agomanya is.

E.L: What are some of socio-cultural characteristics that affect or influence whether a program can be successful in this area as opposed to another area.

M.S.: So don’t be turned off just by thinking, oh healthcare. No, that’s not what it is. We need everybody on board.

E.L.: Some organizations have been successful in linking social marketing and profit making to healthcare. Some organizations have been able to link already profitable programs to healthcare. For example, the Grameen Bank. Known for small-scale finance, but now they’ve realized that they’re working in countries that have healthcare issues, and they’ve been able to tailor their programs to fit the need. So there’s room for everybody at the table, and people need to realize that. My parting message is join REACH, but also realize that there’s room for everybody. It’s just a question of getting involved. Building that spirit of volunteerism, spirit of innovation, and just realizing that it’s all about coming together, working together as a group; because unity is very important.
[Photo Insert: Participant at REACH’s Bukom Happy Hour in D.C. signing up as a REACH member.]

I think that, there’s a quote, I can’t remember, about what Kwame Nkrumah said when he was addressing parliament, less than a year after coming into power. He basically said, that we will be judged as a country by how our healthcare, our education, our children, – are they able to wake up in the morning and eat? Are they able to go to school? Those are the things that a country and a government should be judged on. I think that’s very important. Mandela has another quote that says that the measurement of a society is how they treat the children, and we’re thinking about the future. So I think that the mark of Ghana should be how we help each other out, and how our country progresses, for better healthcare, and even to other things. Healthcare is just one aspect of development.

M.S.: There are people who have said, oh, why Ghana? People in America are struggling with access to healthcare as well. Well, Ghana because there are people who have to travel two hours just to get to a basic healthcare centre. It’s not the same in America. You have an emergency, you can call 911 and someone will get to you in five minutes; in most areas of America. I mean, it’s a different question altogether, it’s not even about who can pay to go, it’s about is it even there. And it’s not there in Ghana, most of the time.

Photo Source: REACH Ghana Facebook Page and Website