Ghana may not require any aid at all …
Yakubu is stoic as she surveys the barren clinic. She tells a story of a man who arrived on a day when it was short-staffed and there was no one to put a tourniquet on his wound. The nearest hospital is an hour and a quarter’s drive away in Walewale, but there are no cars here and the single ambulance that serves the area has to cater for over 100,000 people. The patient died before he could reach hospital.
Yakubu is trained to nurse, but the scope for nursing is limited. “If this place got help, things would go very well and our dreams would be met,” she says.
Bono, lead singer of U2 and a veteran aid activist, is also on the trip representing ONE, the advocacy group he helped set up, which, with various partners, is campaigning for transparency in Africa’s booming commodities industry.
It is also fighting for countries such as the UK to double “smart”, or evidence-based, aid for the Global Fund, founded by former UN secretary general Kofi Annan to fight HIV/Aids, tuberculosis and malaria. He is listening to Yakubu’s story; when she has finished he remarks, partly to himself, and partly to her: “It’s a ghost clinic – it’s a memory of a clinic.”
Prior to the visit to Kpasenkpe, where he teamed up with Sachs – a key architect in creating the Global Fund – Bono hosted a group of senior Republicans from the US Senate in Accra. After visiting Ghana he spent the rest of the week travelling to neighboring countries.
Bono can be a lightning rod for criticism, though few of his critics probably know much about the time he spends in Africa, or his lobbying in the world’s capitals as he pesters foreign leaders for foreign aid. His critics are voluble, but it is difficult to argue with the improvement in the lives of African people who escape the scourges of HIV, TB and malaria as a direct result of the programmes that he and his aid partners support.
For Yakubu, help is, luckily, at hand, since Sachs has travelled here to formally announce that the next “Millennium Village” will be in Kpasenkpe. The Millennium Villages project is led by the Earth Institute, the development organization Millennium Promise and UN agencies. It takes a radical approach to aid, targeting five principal causes of extreme poverty and addressing all of them in an integrated way: health, education, agriculture, rural infrastructure and economic development. The aim is to create one joined-up aid programme instead of having different aid agencies tackling these issues separately.
The most radical aspect of the Millennium Village concept is twofold: firstly, it involves local government and implementation by the communities themselves; and secondly, it is designed to create sustainable communities that will outgrow the need for aid. A village will be subject to rigorous evaluations in order to demonstrate sustainability and scalability, and that aid developed with an exit strategy can actually work.
In an external review of the Millennium Villages project, the Overseas Development Institute recorded crop yield increases of between 85% and 350% and reductions of up to 50% in the incidence of malaria.
It is this evidence-based approach that gives Sachs the confidence to stand in front of what seems like the entire village gathered in the elders’ meeting area to greet the delegation of politicians and development experts. Sachs is unequivocal as he takes the microphone and proclaims, in almost messianic fashion: “You are going to see an improvement in the lives of your people. I promise you, one year from now, your health facility will be functioning and known throughout the region.”
He then lists the improvements to come for farmers, students, mothers, girls in education; it is akin to a stump speech and is greeted with cheers by the locals. “We have five years to make programmes that work for farming, health care, schools, for increasing incomes and improving the lives of your communities. We have a lot of work to do together.”
The Kpasenkpe clinic must wait for the aid to arrive but the omens are promising, because the next day we visit Tema hospital in Accra, which has been receiving aid from the Global Fund. The contrast with Kpasenkpe couldn’t be more stark. And the contrast between the brave but beleaguered Yakubu and Tema staff doctor Patricia Asamoah could not be more marked. Asamoah is positively beaming as she shows us around. This is a happy hospital; a functioning hospital. But it wasn’t always like this.