Drexel ICA Report

Program Overview

The Firm Health Ghana Foundation organized a tailored Intensive Course Abroad (ICA) program in Tarkwa, Ghana, for mental health students from Drexel University’s College of Nursing and Health Professionals in Philadelphia, USA. This unique initiative embraced a community-centric learning approach, offering a comprehensive understanding of Ghana’s mental health landscape, including biomedical and faith-based aspects. Over seven days, participants engaged in diverse community activities, such as mental health discussions, community service, home visits, a visit to a faith-based church, exploration of a cocoa community, a session on cyberbullying, a visit to a small-scale gold mine, and a final presentation at Beyin Beach. The program also included exploration of historical sites like the Cape Coast castle and Nzulezu, providing a holistic experience and broadening perspectives on mental health in the Ghanaian context.

Arrival & Welcome Reception
Saturday: 10th December 2022

The 2022 ICA program participants were picked up at the Kotoka International Airport (Ghana) at about 15:00 GMT and ushered into their respective rooms to settle down following a long trip. A welcome reception was held to welcome all participants to Ghana and also introduce them to executives and volunteers of Firm health Ghana Foundation follow. They were then briefed on the weeks activities. Participants were treated to tasty Ghanaian cuisines and beverages courtesy Donsey Catering Services. Participants also enjoyed pulsating Afrobeats tunes which energized the space. The welcome reception ended around 22:00 GMT. After which all members retired to bed since the following was dedicated to travelling from Accra to Tarkwa in the Western region of Ghana

Days Travel to Tarkwa (Sunday: 11th December 2022)

Participants had breakfast at 7:30 am GMT which included ‘mixed’ Ghanaian delights such as grilled redfish, salad, fried plantain, chicken and beverages. After breakfast, the team had its daily debrief before embarking on an 8-hour bus ride to Tarkwa in the Western region of Ghana with a planned stop-over in Cape Coast. Sylvester Akpah (PhD) gave participants an insight into Ghana, the way of life of the populace, the marketplaces, the weather among others to help participants know what to expect whiles in Ghana. A group photo was taken before departure from Accra. The bus departed Accra at 9:30 am GMT Whilst enroute Cape Coast, the team stopped over briefly toenjoy some fresh road side coconut in one of the coastal towns.At about 13:45 GMT, the team arrived in the Central Region and moved to the Cape Coast Castle to have an insight into the slave trade in Ghana. A volunteer from the castle briefed participants on the Trans-Atlantic slave trade and the significant role the castle played in this sad episode of human history.

The team visited the church, and the Palaver hall (A hall used to determine the health status of slaves before they were finally led into the dungeons). The team and the students were led into the male dungeons, located just below the church of the castle. Visits to the shrine, where the slaves used to worship and the Governor’s chamber were also made. The volunteer then took the team to the forecourt of the castle which holds the graves of, Philip Quarcoo (The first black Anglican pastor), C.B Whitehead, a 38 years old British soldier who was killed by a Dutch soldier in the courtyard and the graves of George Maclean, the British Governor of cape coast from 1830 to 1844 and his wife. The final visits were to the female dungeons and the door of no return leading straight to the sea which when crossed by slaves meant there was to be no more contact with the homeland. The team left Cape Coast at 17:15 GMT after lunch and arrived in Tarkwa around 21:00 GMT. Participants were ushered into their respective rooms to rest and prepare for the next day.

Orientation and Courtesy Calls
Monday: 12th December 2022

The team had breakfast at 7:30 am. To officially commence the 2022 ICA program, the team paid a courtesy call on the Municipal Chief Executive (i.e., the mayor) of Tarkwa-Nsuaem Municipality. Led by Dr Joseph Darko (Director of Medical Services, Firm Health Ghana Foundation), the entire team was duly introduced to the Municipal Chief Executive (MCE) and his team and vice-versa and also gave a detailed breakdown of the week’s itinerary and what is involved. The MCE expressed his delight about the program and urged the team to count on his support and call on him in the event of any difficulties. The MCE expressed his satisfaction with the program outline and wished the international students a pleasant stay.

Courtesy Call on the Municipal Health Directorate.

The team also paid a courtesy call on the Municipal Health Directorate (MHD) which coordinates all medical activities in the municipality. The team was joined by mental health nurses from Apinto Government Hospital. Mad. Veronica Toffey (Head of Public Health) and Mad Mercy Nkrumah (Disease Control Officer for the Municipality) briefed the team on the medical activities and centres in the municipality and the various mental health activities including advocacy undertaken by the MHD. The meeting drew to a close with Dr. Darko thanking the MHD for briefing the team on their mandate in the municipality. He then informed the MHD of activities planned by the team. Courtesy Call.

The group’s next visit was to the Municipal Hospital in Tarkwa. Mr Kofi Duku (Head of the Mental Health Unit at the Hospital) one of the organizers of the program introduced the joint team to the hospital’s management and vice versa The team was warmly welcomed by the hospital’s management represented by Mr Abbass (The Hospital Administrator) and madam Veronica Mensah (Nurse Manager) and briefly educated the team on the history of the hospital, organogram and services rendered by the hospital. Dr Darko then took the team on the structure of the Ghanaian health system in general and in particular the mental health system and its challenges.

The team of participants and nurses were then split into two groups led by Dr Darko and P.A Aagyemang (a physician assistant and one of the organizers of the program) in one group and Dr White and Mr Kofi Duku in the other, the groups then discussed two interesting cases of a possible Tourrette syndrome and another with acute psychotic symptoms. This was followed by presentations by both groups. Following the presentations, the team had a small dance session led by Ms. Linda Williams and Dr White to ease off some stress. two groups, each group received a case study of two different mental health patients. The entire session took almost four hours. Around 15:00 GMT, the team was treated to a tasty lunch of waakye (boiled beans and rice) , macaroni, eggs, fish/meat with shito ( a black spicy sauce) and stew.

At about 17:00 GMT, the team visited the psychiatric unit of Apinto Government Hospital, the second biggest and the only other hospital with a mental health unit in the Tarkwa metropolice. At 18:30 GMT, the group visited Instant Pub and Grill for their first home dinner. Participants were treated to the ever-delicious Ghana Jollof, goat soup, boiled yam (with garden egg stew or palaver sauce), fried chicken and fish. As usual, the space was energized by some afrobeat music to which all danced gleefully.

A visit to Acklica (Tuesday: 13th December 2022)

After having breakfast around 7:30 am, the team traveled to Aklica, a cocoa farming community about an hour's drive from Tarkwa. To access the community, the team navigated across the Bonsa River with a canoe before trekking through some cocoa farms to the chief’s palace to interact with the chief and his elders. The team discussed their mission with the chief through his linguist. After 10 minutes of interaction, the team thanked the chief on behalf of his community and proceeded to the only school in the community. The group walked for 45 minutes through cocoa farms before arriving at the school.

At the school, the team joined a Parents Teachers Association (PTA) meeting that was being held. As customary, introductions were done on both sides, after which engagements were held with the parents and teachers in one of the classrooms. Following the engagements, the best cocoa farmers in the community were tasked to take the students through the primary processes involved in cocoa harvesting and seed preparation before exportation out of the community to be processed into chocolate both locally and internationally. The team had interesting interactions with the farmers, inquiring about their understanding of mental health and what they considered to be a mental health disorder, among other topics, to which the farmers gave very interesting answers.

The team was also taken through how to weigh sacks of dried cocoa beans. After the interactions, the team was treated to some fresh coconut water and fruits to quench their thirst after a long walk on a sunny day. The team was then rowed across the Bonsa River once more to join their waiting bus and headed straight to Fiaseman Senior High School (FIASEC) around 15:30 GMT to interact with the students on cyberbullying and how to maintain sanity in the era of social media.

Interaction with Students of Fiaseman Senior High School.

The team arrived at the school at 16:30, having lunch on the bus. By 16:45 GMT, they engaged with school teachers and over 500 students in the assembly hall. Dr. Ebony White introduced the session, and participating students discussed mental health, emphasizing the significance of maintaining well-being in the era of cyberbullying on social media. They shared personal experiences, instances of social media bullying, its impact, and coping mechanisms, highlighting the importance of family and friends' support. Dr. Darko concluded by discussing the availability of mental health services for high school students, encouraging both teachers and students to utilize them. The team then departed for dinner at the Ghana Manganese Company’s restaurant." (178 words)

Radio Discussions
Wednesday: 14th December 2022

After breakfast at 7:30 am, the team, including nurses from the mental health unit of the Apinto Government Hospital, was divided into two groups to visit two radio stations for an hour's discussion on the complex interaction between biomedical and faith-based approaches to mental health in Ghana. The first group went to Dynamite FM, while the second went to Mining City FM, both popular stations in Tarkwa and its environs. Discussions were conducted in both Twi (a local language) and English to ensure maximum reach. The teams educated the public on the roles both approaches play in mental health, highlighting various mental health units and advocacy programs in the municipality. This interactive session concluded with a phone-in segment where listeners asked thought-provoking questions. After the radio segment, the team visited the homes of individuals and families with mental health disorders.

Psychiatric Hospital and Faith-Based (Thursday: 15th December 2022)

Psychiatric Hospital Visitation

After breakfast, the team left Tarkwa for Ankaful Psychiatric Hospital, arriving after a five-hour journey in the Central region of Ghana. The visit provided insight into managing patients with serious mental health disorders. Led by the hospital's internship coordinator, a psychiatric nurse, the session covered Ghana's mental health history, the impact of the Mental Health Act, and challenges in implementation, particularly in the south. Medications, drug supply challenges, and general management were discussed. The team toured wards to observe the hospital's setup, actively engaging with the coordinator and receiving informative answers.

Faith-Based Church Visitation

The journey from Ankaful to the Mount Horeb prayer camp took a little over an hour. The team received a warm welcome from the church’s founder and elders. The spokesperson recounted the past practice of chaining mentally ill individuals to trees and explained how the church transformed into a healing center for mental health disorders. He highlighted the evolution from solely relying on prayers and fasting to incorporating medical assistance following a directive from the municipality’s medical director. The team was shown patients at various stages of recovery, emphasizing the cooperative relationship between the camp and the health department.

During the Faith-Based Church Visitation, the joint team toured the camp, resembling a growing community. They asked questions to the founders and nurses before embarking on a five-hour journey to Beyin beach in the Jomoro district of the Western Region of Ghana. The team arrived at the beach past midnight but remained awake, working on their final presentations with a bonfire, music, and the cool ocean breeze. Team members later retired to their respective tents for a well-deserved rest on their well-inflated air beds.

Beach Presentation and Cultural Visit
Friday: 16th December 2022

After a relaxing night, the team awoke to a beautiful sunrise over the Atlantic Ocean from their tents. Breakfast was served at exactly 8:00 am. Team members took advantage of the tranquil atmosphere to enjoy the beach and prepare for the final presentations scheduled for 4 pm. The entire morning and early afternoon were left open for participants to relax and savor the oceanfront while preparing for their respective final presentations later in the day. At 2 pm, the team paid a cultural visit to Nzulenzu, a floating village near the beach. The visit required a 20-minute boat ride across the freshwater lake, providing an exhilarating experience as the boat glided across the wide, natural lake surrounded by bushes and forests. The team took a quick tour of the town, led by the tour guide, visiting places of interest in the village, including the only junior high school. The tour ended with a dance session in a floating bar.

Final Presentation and Cultural Dance

At 16:00, the team returned to the beach for the final presentation. The students were divided into pairs, and this engaging learning session involved each pair sharing their experiences and how the program had influenced their perspectives on mental health and life in general. Participants articulated what they were taking back home with them, and thoughtful questions were asked, accompanied by some personal experiences and shared tears. Each group session concluded with fun and meaningful activities to reinforce the presentations' messages. Dr. Darko provided initial feedback on presentations and pre-travel essays, promising detailed responses in due course. The emotional session ended with the exchange of gifts and a meal from Donsey Kitchen and Grill. The night continued with a feast and cultural dance troupe performance, charging the atmosphere further. Participants showcased their dance skills in the sand, and the night concluded with bonfire, barbecue, and karaoke, marking the final night in Ghana after a week of transformative experiences.

Journey to Accra and Departure
Saturday: 17th December 2022

The next morning, team members engaged in various activities, including beach walks, runs, relaxation, and even yoga against the rising sun. After breakfast, the team prepared and packed up for a seven-hour journey back to Accra and departure. Most of the journey was utilized to catch up on much-needed sleep after a long and exciting night. Following a restful seven-hour journey, the team arrived in Accra. Sylvester Akpah (PhD) led an interesting closing session where each team member, including participants and hosts, described what the experience meant to them and how their perspectives on mental health and life had been influenced by the program. He expressed gratitude for their roles in ensuring a successful, life-altering program. Dr. Ebony White, representing all participants, thanked Firm Health Ghana Foundation for organizing such a life-changing program and being warm hosts, wishing for a stronger relationship between both institutions moving forward. Participants were dropped off at the airport, and despite the program's success, farewells were tearful hugs, signaling the end of the Winter ICA 2022 program in Ghana.