School Health in Ghana

In Ghana the government provides public education from daycare to senior high school, although there are private schooling options. Primary school year one (first grade) to junior high year three (ninth grade) is considered Ghana's "basic education", and to enter high school students must take the Basic Education Certificate Exam (BECE). At this point the children age from fourteen to sixteen with a handful of students who start school late who are eighteen or nineteen. Most of the students in the public system come from families who do not have a lot of money or are on their own, some are the parental figures in the home and therefore are responsible for, sometimes several, younger siblings. To ask these students to put their focus on the BECE and be able to go to university following high school is a tall order, needless to say their high school placement depends on their score. One can imagine how stressed these students are.

I went to a Ghanaian junior high to provide sex education and quick wellness exams to the students. The students were buzzing with excitement at our arrival and raced to windows to wave at us. We went to the headmistress' office first to introduce ourselves. She was a very strict and formidable presence, even I was intimidated, let alone if I was one of her students. The sex ed class went as any sex ed would, with a lot of giggling and shy looks. Afterwards we took their weights and heights and our medical student and two other hospital residents conducted basic physical exams. As we calculated BMI's most kids had BMI's under 20 and if they were over 20 they were borderline overweight. One boy stuck out to me since he was 14 and barely over four feet tall and 50 pounds. He was also responsible for two younger siblings which was not unusual as many of the other junior high students' younger siblings came over to them. The children also had a lot of questions for us. Like, I think I lost my voice answering them. Some questions were: "Is there snow where you live?", "Do you have elephants in your forests?" (Imagine an elephant in Seattle!) And I got some pretty hard questions like "Can you have gays and lesbians in your home?", "Do you use bleaching cream on your skin?" I chose to not answer the former and tried to explain why the girls should not bleach their skin and we should be happy with what we were born with. Overall, it was fun to speak to them about our respective cultures. Afterwards we reconvened and spoke to the headmistress about what health issues were a problem. Many kids had dental problems and just as many had unresolved respiratory problems, let alone the obvious malnutrition in others. It was obvious these children do not go to regular physicals, actually insurance in Ghana does not pay for well child exams. Our visit to the school may very well be the physical exam that they even receive in that year, but they were still so spirited.

This trip was made me reflect of my own educational career. I will be the last person to deny that I was VERY fortunate in my education. That I cannot say for these students. The most technological tool in this school was a whiteboard, classrooms did not even have electricity. The students at the school were so bright, intelligent, and curious. They enjoy being at school and learning, something students in America take for granted. I wish nothing more than for these students to have more tools to succeed. People need to advocate for these students so their schools get more funding, or at least make sure their health is taken care of such that they CAN stay in school.